Responsiveness Assessment and Its Influencing Factors of Community Health Services among Residents of Different Ages

Abstract

Background Responsiveness is a key goal in evaluating the performance of the health system, and is also an essential basis for improving the capacity of primary health services. Currently, many studies confuse the concepts of responsiveness and satisfaction, and the evaluation of responsiveness is not comprehensive enough, focusing on the level of responsiveness but ignoring its distribution. Objective To understand the responsiveness evaluations of community health services among residents of different ages in Zhejiang province and to analyze its influencing factors. Methods Utilizing the method of purposive sampling and convenience sampling, six community health service centers in Hangzhou and Taizhou, Zhejiang province, were selected as the investigation sites from July to August 2022 to assess the responsiveness scale of outpatient residents. The weights of the eight components of responsiveness recommended by the WHO were used to calculate the overall level and distribution of responsiveness. Univariate analysis and multiple linear regression were used to explore the influencing factors on the responsiveness level among residents of different ages. Results The score of responsiveness for community health services in Zhejiang was (8.31±1.04) points, and the responsiveness distribution index was 0.13; residents of different age groups expressed their higher satisfaction with the dimensions of dignity and social support, with scores of (8.60±1.24) points and (8.63±1.20) points, respectively. In contrast, the dimensions of selectivity and autonomy received lower ratings, with scores of (7.96±1.56) points and (8.04±1.34) points, respectively. Household registration was an influencing factor for responsiveness evaluation of community health services among young people, while education level and monthly income were influencing factors for responsiveness evaluation among middle-aged individuals (P<0.05) . Conclusion The overall level of community health service responsiveness in Zhejiang province is good, and the distribution is more balanced. More attention should be paid to the demand and responsiveness of community health services among young people with urban household registration and middle-aged people with a college/bachelor's degree or above. Primary care community health service centers still need to improve in providing patients with access to information about health service plans and the freedom to choose community doctors/nurses, thereby better satisfying the reasonable healthcare service demands of residents.

Keywords

• community health services|responsiveness|cross-sectional studies|root cause analysis|multiple linear regression