A SYSTEMATIC REVIEW ON RESPONSIVENESS IN HEALTH SYSTEMS

Öz

The present study aims to analyze international studies on responsiveness in health systems by systematic review method. In the study, the "PRISMA" directive developed for systematic reviews and meta-analyses was used, and 27 studies meeting the inclusion criteria were included in the study. As a result of the analysis, it was determined that the greatest number of studies on responsiveness in health systems were carried out in 2017 (n=5) and the country with the most studies was Iran (25.9%). In most of the studies reviewed, outpatients and inpatients (29.6%) were evaluated together. Respectful treatment (25.9%), confidentiality (22.2%) and social support (18.5%) get the highest scores from the responsiveness sub-dimensions; the lowest scoring dimensions are choice (37.04%) and autonomy (25.9%). In addition, it was determined that its responsiveness was affected by variables such as gender, age, education level, place of residence and service type. The measurement of responsiveness is used in the performance evaluation of both the general health system and specific health services. The findings obtained from this study on responsiveness studies, by presenting a holistic and in-depth perspective, can guide the studies to be carried out in the evaluation of the health system at the national level and bring the studies to the agenda.

Anahtar Kelimeler

• Health policy
• health services
• performance
• quality
• responsiveness.

SAĞLIK SİSTEMLERİNDE CEVAP VEREBİLİRLİK ÜZERİNE SİSTEMATİK BİR DERLEME

Öz

Bu çalışmada, sağlık sistemlerinde cevap verebilirlik üzerine yapılan uluslararası çalışmaların sistematik derleme yöntemi ile analiz edilmesi amaçlanmıştır. Çalışmada, sistematik incelemeler ve meta analizleri için geliştirilen “PRISMA” yönergesi kullanılmış, belirlenen dahil edilme kriterleri doğrultusunda ulaşılan 27 çalışma araştırma kapsamına alınmıştır. İnceleme sonucunda sağlık sistemlerinde cevap verebilirlik üzerine yapılmış çalışmaların en fazla 2017 yılında gerçekleştirildiği (n=5) ve en fazla çalışma yapılan ülkenin İran (%25.9) olduğu belirlenmiştir. İncelenen çalışmaların büyük kısmında ayakta ve yatan hastalar (%29.6) birlikte değerlendirilmiştir. Cevap verebilirlik alt boyutlarından en yüksek puanı alan alt boyutlar, saygılı tedavi (%25.9), gizlilik (%22.2) ve sosyal destek (%18.5); en düşük puanı alan boyutlar, seçim (%37.04) ve otonomi (%25.9)’dir. Ayrıca cevap verebilirliğinin cinsiyet, yaş, eğitim seviyesi, yerleşim yeri ve hizmet türü gibi değişkenlerden etkilendiği saptanmıştır. Cevap verebilirliğin ölçümü, hem genel sağlık sistemi hem de belirli sağlık hizmetlerinin performans değerlendirmesinde kullanılmaktadır. Cevap verebilirlik çalışmaları üzerinde yapılan bu araştırmada elde edilen bulgular, bütüncül ve derinlemesine bir perspektif sunarak, ulusal düzeyde sağlık sisteminin değerlendirilmesinde yapılacak çalışmalara rehber olabilir, çalışmaların gündeme gelmesini sağlayabilir.

Anahtar Kelimeler

• sağlık politikası
• Cevap verebilirlik
• kalite
• performans
• sağlık hizmeti

Kaynakça

1. 1. Sargutan AE. Sağlık sektörü ve sağlık sistemlerinin yapısı. Hacettepe Sağlık İdaresi Dergisi 2005; 8(3): 400-428.
2. 2. Baharvand P. Responsiveness of the health system towards patients admitted to west of Iran hospitals. Electronic Journal of General Medicine 2019; 16(2): 1-7.
3. 3. DSÖ. The World Health Report 2000. Health Systems: Improving Performance.World Health Organization, Genava 2000.
4. 4. Uğurluoğlu Ö, Çelik Y. Sağlık Sistemleri Performans Ölçümü, Önemi ve Dünya Sağlık Örgütü Yaklaşımı. Hacettepe Sağlık İdaresi Dergisi 2005; 8(1): 3-29.
5. 5. Ebrahimipour H, Najjar AV, Jahani AK, et al. Health system responsiveness: a case study of general hospitals in Iran. Int J Health Policy Manag 2013; 1(1): 85-90.
6. 6. Awoke MA, Negin J, Moller J, et al. Predictors of public and private healthcare utilization and associated health system responsiveness among older adults in Ghana. Glob Health Action 2017; 10(1): 1-10.
7. 7. Mirzoev T, Kane S. What is health systems responsiveness? Review of existing knowledge and proposed conceptual framework. BMJ Glob Health 2017; 2(4): 1-11.
8. 8. Hsu CC, Chen L, Hu YW, Yıp W, Shu CC. The dimensions of responsiveness of a health system: a Taiwanese perspective. BMC Public Health 2006; 6(1): 72-79.

9. 9. De Silva AA. Framework for Measuring Responsiveness. World Health Organization, Genava 2000.
10. 10. Valentine N, Darby C, Bonsel GJ. Which aspects of non-clinical quality of care are most important? Results from WHO's general population surveys of “health systems responsiveness” in 41 countries, Social science & medicine. 2008; 66(9): 1939-1950.
11. 11. Akalın B. Sağlık Sisteminde Cevap Verebilirlik. Hiperyayın, İstanbul 2018.
12. 12. Darby C, Valentina N, Murray CJL, De Silva A. World Health Organization (WHO) :Strategy On Measuring Responsiveness. World Health Organization, Genava 2000.
13. 13. Üstün TB, Chatterji S, Villanueva M, et al. WHO multi-country survey study on health and responsiveness. World Health Organization, Genava 2001.
14. 14. Coulter A, Jenkinson C. European patients' views on the responsiveness of health systems and healthcare providers. Eur J Public Health 2005; 15(4): 355-360.
15. 15. Adesanya T, Gbolahan O, Ghannam O, et al. Exploring the responsiveness of public and private hospitals in Lagos, Nigeria. J Public Health Res 2012, 1(1), 2-7.
16. 16. Rottger J, Blumel M, Fuchs S, Busse R. Assessing the responsiveness of chronic disease care-Is the World Health Organization's concept of health system responsiveness applicable?. Social Science & Medicine 2014; 113: 87-94.
17. 17. Chao J, Lu B, Zhang H, Zhu L, Jin H, Liu P. Healthcare system responsiveness in Jiangsu Province, China. BMC Health Serv Res 2017; 17(1): 31-38.
18. 18. Uğurluoğlu O, Çelik Y. How responsive Turkish health care system is to its citizens: the views of hospital managers. Journal of medical systems 2006; 30(6): 421-428.
19. 19. Akalın B. The Responsiveness of Inpatient Healthcare Institutions: The Case of a Training and Research Hospital. Journal of Current Researches on Health Sector 2018; 8(2): 321-336.
20. 20. Torgerson C. Systematic reviews. Bloomsbury Publishing, New York 2003.
21. 21. Karaçam Z. Sistematik derleme metodolojisi: Sistematik derleme hazırlamak için bir rehber. Dokuz Eylül Üniversitesi Hemşirelik Fakültesi Elektronik Dergisi 2013; 6(1): 26-33.
22. 22. Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS med 2009; 6(7): 1-8.
23. 23. Bramesfeld A, Klippel U, Seidel G, Schwartz FW, Dierks ML. How do patients expect the mental health service system to act? Testing the WHO responsiveness concept for its appropriateness in mental health care. Social science & medicine 2007; 65(5): 880-889.
24. 24. Njeru MK, Blystad A, Nyamongo IK, Fylkesnes KA. Critical assessment of the WHO responsiveness tool: lessons from voluntary HIV testing and counselling services in Kenya. BMC Health Serv Res 2009; 9(1): 243-254.
25. 25. Peltzer K, Mafuya PN. Patient experiences and health system responsiveness among older adults in South Africa. Glob Health Action 2012; 5(1): 1-12.
26. 26. Liabsuetrakul T, Petmanee P, Sanguanchua S, Oumudee N. Health system responsiveness for delivery care in Southern Thailand. Int J Qual Health Care 2012; 24(2): 169-175.
27. 27. Tanha KF, 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): 736-740.
28. 28. Yakob B, Ncama BP. Measuring health system responsiveness at facility level in Ethiopia: performance, correlates and implications. BMC Health Serv Res 2017; 17(1): 263-27.
29. 29. Mohammed S, Bermejo JL, Souares A, Sauerborn R, Dong H. Assessing responsiveness of health care services within a health insurance scheme in Nigeria: users’ perspectives. BMC Health Serv Res 2013; 13(1): 502-515.
30. 30. Ughasoro MD, Okanya OC, Uzochukwu BSC, Onwujekwe OE. An exploratory study of patients’ perceptions of responsiveness of tertiary health-care services in Southeast Nigeria: A hospital-based cross-sectional study. Nigerian Journal of Clinical Practice 2017; 20(3): 267-273.
31. 31. Ali FMH, Nikoloski Z, Reka H. Satisfaction and responsiveness with health-care services in Qatar-evidence from a survey. Health Policy 2015; 119(11): 1499-1505.
32. 32. Mohammadi A, Koorosh K. Responsiveness in the healthcare settings: a survey of inpatients, International Journal of Hospital Research 2014; 3(3): 123-132.
33. 33. Tille F, Rottger J, Gibis B, Busse R, Kuhlmey A, Schnitzer S. Patients’ perceptions of health system responsiveness in ambulatory care in Germany. Patient Education and Counseling 2019; 102(1): 162-171.
34. 34. Malhotra C, Do YK. Socio-economic disparities in health system responsiveness in India. Health Policy Plan 2013; 28(2): 197-205.
35. 35. Melo DDS, Martins RD, Jesus RPSD, Samico IC, Santo ACGDE. Assessment of the responsiveness of a public health service from the perspective of older adults. Revista de saude publica 2017; 51: 62-72.
36. 36. Najafi F, Karami-Matin B, Rezaei S, Rajabi-Gilan N, Soofi M. Health system responsiveness after health sector evolution plan (HSEP): An inpatient survey in Kermanshah in 2015. Med J Islam Repub Iran 2016; 30: 387-394.
37. 37. Kapologwe NA, Kibusi SM, Borghi J, Gwajıma DO, Kalolo A, Assessing health system responsiveness in primary health care facilities in Tanzania. BMC Health Serv Res 2020; 20(1): 104-114.
38. 38. Peltzer K. Patient experiences and health system responsiveness in South Africa. BMC Health Serv Res 2009; 9(1): 117-129.
39. 39. 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 Med J 2011; 13(5): 302-309.
40. 40. Forouzan AS, Ghazinour M, Dejman M, Rafeiey H, Sebastian M. Testing the WHO responsiveness concept in the Iranian mental healthcare system: a qualitative study of service users. BMC Health Serv Res 2011; 11(1): 325-335.
41. 41. Almeida C, Braveman P, Gold MR, et al. Methodological concerns and recommendations on policy consequences of the World Health Report 2000. Lancet 2001; 357(9269): 1692-1697.
42. 42. Kooy J, Valentine NB, Birnie E, et al. Validity of a questionnaire measuring the world health organization concept of health system responsiveness with respect to perinatal services in the Dutch obstetric care system. BMC Health Serv Res 2014; 14(1): 622-635.
43. 43. Valentine NB, Salomon JA. Weights for responsiveness domains: analysis of country variation in 65 national sample surveys. In: Murray C.J.L., Evans D.B., eds.: Health system performance assessment: debates, methods and empiricism, World Health Organization Genava 2003.
44. 44. Vandan N, Wong JH, Gong WJ, Yıp PF, Fong DT. Health system responsiveness in Hong Kong: a comparison between South Asian and Chinese patients’ experiences. Public Health 2020; 182: 81-87.
45. 45. Ergler CR, Sakdapolrak P, Bohle HG, Kearns RA. Entitlements to health care: why is there a preference for private facilities among poorer residents of Chennai, India? Social Science & Medicine 2010; 72: 327-337.
46. 46. Şantaş F, Kurşun A, Kar A. Hastane Tercihine Etki Eden Faktörler: Sağlık Hizmetleri Pazarlaması Perspektifinden Alan Araştırması. Hacettepe Sağlık İdaresi Dergisi 2016; 19(1): 17-33.
47. 47. Luo Q, Wang Q, Lu Z, Liu J. Evaluation of responsiveness of community health services in urban China: a quantitative study in Wuhan City. PLoS One 2013; 8(5): 1-8.
48. 48. Gromulska L, Gorynski P, Supranowicz P, Wysocki MJ. Responsiveness to the hospital patient needs in Poland. Roczniki Państwowego Zakładu Higieny 2014; 65(2): 155-164.
49. 49. Kashkoli SA, Zarei E, Daneshkohan A, Khodakarım S. Hospital responsiveness and its effect on overall patient satisfaction. International Journal of Health Care Quality Assurance 2017; 30(8): 728-736.
50. 50. Babu BV, Sharma Y, Kusuma YS, et al. Patient experiences and health system responsiveness among internal migrants: A nationwide study in 13 Indian cities. Journal of Healthcare Quality Research 2019; 34(4): 167-175.