IF: 0.644

Assessing Health System Responsiveness: A Household Survey in 17th District of Tehran


A Rashidian 1 , Z Kavosi 2 , R Majdzadeh 1 , AGh Pourreza 3 , * , F Pourmalek 4 , M Arab 1 , K Mohammad 1


1 Department of Health Management and Economics, School of Public Health, Knowledge Utilization Research Center, Director, National Institute of Health Research, Tehran University of Medical Sciences, Tehran, Iran

2 Department of Health Management and Economics, School of Public Health, Department of Management and Medical Informatics, Shiraz University of Medical Sciences, Fars, Iran

3 Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, porrezaa@sina.tums.ac.ir, Tehran, Iran

4 Institute for Health Metrics and Evaluation, University of Washington, USA


Iranian Red Crescent Medical Journal: 13 (5); 302-308
Article Type: Research Article
Received: August 25, 2010
Accepted: November 10, 2010




Background: Responsiveness is an indicator by WHO to evaluate the performance of health systems on non-medical expectations of consumers. This study measures the health system responsiveness and the factors affecting responsiveness in Iran health system.

Methods: World Health Survey (WHS) questionnaire was used to collect data on a two-stage cluster sample in 17th District of Tehran in 2003. Of a sample of 773, 677 and 299 individuals who respectively had outpatient or inpatient services utilization responded to the responsiveness module of WHS questionnaire.

Result: More than 90% of respondents believed that responsiveness issues were very important. Performance of outpatient services was better than hospital services in terms of responsiveness. "Prompt attention" and "quality of basic amenities" received low score for outpatient services. Service user variables had no significant effect on responsiveness, while type of centers was significantly related to responsiveness. Principal component analysis found three factors for both outpatient and inpatient services that explained 62% and 61% of total variances respectfully.

Conclusion: Iran health system should pay more attention to responding non-medical expectations of service users. It sounds that health system interventions are main determinant of responsiveness score compared to demographic or user variables. Training health staff, allocating more resources and reengineering some processes may play a role in improving responsiveness. Responsiveness domains seems to be tailored based on each society's cultural factors. 


Responsiveness Outpatient services Inpatient services WHS Iran

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