Journal of Paramedical Sciences & Rehabilitation

Journal of Paramedical Sciences & Rehabilitation

Responsiveness of the Health System in Outpatient Services in Low and High Income Areas of Mashhad

Document Type : Original Article

Authors
somayeh Fazaeli 1
M Yousefi 2
H Ebrahimipour 3
H Banikazemi 2
A khorsand vakilzadeh 4
1 Medical Records and Health Information Technology Department, school of paramedical sciences, Mashhad University of Medical Sciences, Mashhad, Iran
2 Health Strategic Research Center, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
3 Health Sciences Research Center, Department of Health and Management, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
4 Department of Complementary and Chines Medicine, School of Persian and Complementary Medicine, Mashhad University of Medical Sciences
10.22038/jpsr.2016.6912
Abstract
Purpose:
Outpatient services are a significant part of the health care delivery system. Dominance of the non-governmental sector in delivery of these services along with the government stewardship role in health system indicates the importance of monitoring the non-clinical aspects of quality in the outpatient services. The aim of this study was to evaluate the Responsiveness of the health system in the sector of outpatient services for households living in selected areas in Mashhad.
Methods:
This descriptive-applied study was performed as a cross sectional in 2014. The sample size included 1000 households that selected by multistage sampling from low and high income areas of Mashhad. Data was collected by WHO questionnaire which had three parts and its validity and reliability were assessed and approved. Data were analyzed by Descriptive and inferential statistics in SPSS.
Results:
The findings generally showed that more than 60 percent of the responders, expressed outpatient services responsiveness as good. The aspects of confidentiality and the quality of the amenities, acquired the highest and lowest level from the respondents view, respectively. The level of responsiveness from the view of residents in the high income area has been reported higher than the low income area.
Conclusions:
Quality of health services should be a goal that can be achieved with a good stewardship in the health system. Since most institutions that providing outpatient services are outside of the Ministry of Health as a stewardship of health system of Iran, establishing the appropriate mechanisms to monitor of this goal seems necessary.
Keywords
Health system
Outpatient services
Responsiveness
  1. Mosaddegh Rad AM, textbook of specialized hospital organization and management. Dibagaran-e- Tehran 2006; 1:  295. [Persian]
  2. Sadghiani A. textbook of Hospital Organization and Management. Jahan rayaneh. Tehran; 1: 1999: 295.[Persian]
  3. Ansari H, Ebadi Fard Azar F. Principles of Hospital Administration and Planning,Tehran, Medical University of Iran Publication, Iran;1998. [In Persian].
  4. Maleki m, karimi sh. Review of factors affecting hospital stay in Australia using the delphi technique, Journal of Iran University of Medical Sciences 2001; 9: 12-19. [Persian]
  5. Ainparast A. Estimated waiting time for outpatients and factors in the Orthopedic clinics of hospitals affiliated to Tehran university of medical sciences [MS.c Thesis].Tehran university of medical sciences; 2000. [Persian]
  6.  Fazaeli S, Ahmadi M, Rashidian A, Sadoughi F. A Framework of a Health System Responsiveness Assessment Information System for Iran. Iranian Red Crescent medical journal 2014; 16(6). [Persian]
  7.  Nicole B, Valentine, de Silva A, Kei Kawabata, Charles Darby, J.L. C, et al. Health System Responsiveness: Concepts, Domains and Operationalization. In "Murray CJL, Evans DB Health System Performance Assessment (Debates, Methods and Empiricism)". geneva: World Health Organization; 2003: 573-596.
  8. Keating NL, Green DC, Kao AC, Gazmararian JA, Wu VY, Cleary PD. How are patients' specific ambulatory care experiences related to trust, satisfaction, and considering changing physicians? Journal of General Internal Medicine 2002; 17(1): 29-39.
  9. Wensing M, Elwyn G. Methods for incorporating patients' views in health care. Bmj 2003; 326(7394): 877-9.
  10. Rashidian A, Kavosi Z, Majdzadeh R, Pourreza A, Pourmalek F, Arab M, et al. Assessing health system responsiveness: a household survey in 17th district of tehran. Iran Red Crescent Medical journal 2011; 13(5): 302-8.
  11. Karami-Tanha F, Moradi-Lakeh M, Fallah-Abadi H, Nojomi M. Health System Responsiveness for Care of Patients with Heart Failure: Evidence form a University Hospital. Archives of Iranian medicine 2014; 17(11): 36-40.
  12. Leddy Km, Kaldenberg Do, Becker Bw. Timeliness in ambulatory care treatment: an examination of patient satisfaction and wait times in medical practices and outpatient test and treatment facilities. The Journal of ambulatory care management 2003; 26(2): 138-49.
  13. Rezaei F, Askari HA. Checking the relationship between physicians' communication skills and outpatients' satisfaction in the clinics of Isfahan Al-Zahra(S) Hospital in 2011. Journal of education and health promotion 2014; 3: 105.
  14. Farmahini Farahani M, Shamsikhani S, Sajadi Hezaveh M. Patient satisfaction with nursing and medical care in hospitals affiliated to Arak University of medical sciences in 2009. Nursing and midwifery studies 2014; 3(3): e14022.
  15. Jafari Kelarijani SE, Jamshidi R, Heidarian AR, Khorshidi M. Evaluation of factors influencing patient satisfaction in social security hospitals in Mazandaran province, North of Iran. Caspian journal of internal medicine 2014; 5(4): 232-4.
  16. Fazaeli S, Ahmadi M, Rashidian A, Sadoughi F. A Framework of a Health System Responsiveness Assessment Information System for Iran. Iranian Red Crescent medical journal 2014; 16(6):10-14.
  17.  Nicole B, Valentine, de Silva A, Kei Kawabata, Charles Darby, J.L. C, et al. Health System Responsiveness: Concepts, Domains and Operationalization. in "Murray CJL, Evans DB Health System Performance Assessment (Debates, Methods and Empiricism)". geneva: World Health Organization; 2003:chapter 43:573.
  18. yousefi, A. A reflection on the social boundaries of urban space Mashhad, Mashhad, position Classification. Journal of Social Sciences 2010; 6(2): 61-91.
  19. Asghari S, Malekafzali H, Holakouie Naieni K, Majdzadeh R, Soleimani F, Amirsalari S. Health service utilization by mentally handicapped children and factors affecting it. Journal of School of Public Health and Institute of Public Health Research. [MS.c Thesis] 2007; 5(1): 29-37. [Persian]
  20.  Yousefi M, Assari Arani A, Sahabi B, Kazemnejad A, Fazaeli S. Household Health Costs: Direct, Indirect And Intangible. Iranian Journal of Public Health 2014; 43(2): 202-9. [Persian]
  21.  Kowal P, Naidoo N, Williams S.R, Chatterji S. Performance of the health system inChina and Asia as measured by responsiveness. Health 2011; 3(10): 638-48.
  22. Khamseh M.E., Aghili R., Baradaran H.R., Arabi A. Article Title: Patients satisfaction of medical care delivered in outpatient clinics of endocrinology and metabolism in Tehran, Iran.  January 2007;6(1): 71-74 .[Persian]
  23.  Quintana JM, Gonzalez N, Bilbao A, Aizpuru F, Escobar A, Esteban C. Predictors of patient satisfaction with hospital health care. BMC Health Services Research 2006; 6: 1-9.
  24. Jaipaul CK, Rosenthal GE. Are older patients more satisfied with hospital care than younger patients? J Gen Intern Med 2003; 18(1): 23-30.
  25. OrtizJ. Inequality in Responsiveness: Population Surveys from 16 OECD Countries. in "Murray CJL, Evans DB Health System Performance Assessment (Debates, Methods and Empiricism)". geneva: World Health Organization; 2003: 653 - 663.
  26. Ebrahimipour H, Najjar AV, Jahani AK, Pourtaleb A, Javadi M, Rezazadeh A, et al. Health system responsiveness: a case study of general hospitals in Iran. International journal of health policy and management 2013; 1(1): 85.
  27. Yazdi NA, Tavafian SS, Emadzadeh A, Kazemnejad A, Ghofranipour F. Communication training and patient satisfaction: A randomized trial study from Mashhad, Iran. Patient preference and adherence 2008; 2: 137-142.
  28. Saadati Z. Satisfaction of clients referring to emergency wards of a teaching hospital in Mashhad city 2006; 16(25): 40 - 47.
  29. Üstün TB, et al. WHO Multi-country Survey Study on Health and Responsiveness 2000–2001. In "Murray CJL, Evans DB Health System Performance Assessment (Debates, Methods and Empiricism)". Geneva: World Health Organization; 2003: chapter44.
Journal of Paramedical Sciences & Rehabilitation
Volume 5, Issue 2
Spring 2016
Pages 58-66