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Assessing the responsiveness of chronic disease care - Is the World Health Organization's concept of health system responsiveness applicable?

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  • Röttger, Julia
  • Blümel, Miriam
  • Fuchs, Sabine
  • Busse, Reinhard

Abstract

The concept of health system responsiveness is an important dimension of health system performance assessment. Further efforts have been made in recent years to improve the analysis of responsiveness measurements, yet few studies have applied the responsiveness concept to the evaluation of specific health care delivery structures. The objective of this study was to test the World Health Organization's (WHO's) responsiveness concept for an application in the evaluation of chronic disease care. In September and October 2012 we conducted four focus groups of chronically ill people (n = 38) in Germany, in which participants discussed their experiences and expectations regarding health care. The data was analyzed deductively (on the basis of the WHO responsiveness concept) and inductively using directed content analysis. Ten themes related to health system responsiveness and one theme (finances) not directly related to health system responsiveness, but of high importance to the focus group participants, could be identified. Eight of the ten responsiveness themes are consistent with the WHO concept. Additionally, two new themes were identified: trust (consultation and treatment are not led by any motive other than the patients' wellbeing) and coordination (treatment involving different providers is coordinated and different actors communicate with each other). These findings indicate the suitability of the WHO responsiveness concept for the evaluation of chronic disease care. However, some amendments, in particular an extension of the concept to include the two domains trust and coordination, are necessary for a thorough assessment of the responsiveness of chronic disease care.

Suggested Citation

  • Röttger, Julia & Blümel, Miriam & Fuchs, Sabine & Busse, Reinhard, 2014. "Assessing the responsiveness of chronic disease care - Is the World Health Organization's concept of health system responsiveness applicable?," Social Science & Medicine, Elsevier, vol. 113(C), pages 87-94.
    • Handle: RePEc:eee:socmed:v:113:y:2014:i:c:p:87-94
    DOI: 10.1016/j.socscimed.2014.05.009
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    References listed on IDEAS

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    1. Williams, Brian, 1994. "Patient satisfaction: A valid concept?," Social Science & Medicine, Elsevier, vol. 38(4), pages 509-516, February.
    2. Nigel Rice & Silvana Robone & Peter Smith, 2011. "Analysis of the validity of the vignette approach to correct for heterogeneity in reporting health system responsiveness," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 12(2), pages 141-162, April.
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    1. Kolosnitsyna, Marina (Колосницына, Марина) & Khorkina, Natalia (Хоркина, Наталья) & Dorjiev, Khongor (Доржиев, Хонгор), 2015. "The impact of price measures of state alcohol policy on the consumption of alcoholic beverages in Russia [Влияние Ценовых Мер Государственной Антиалкогольной Политики На Потребление Спиртных Напитк," Ekonomicheskaya Politika / Economic Policy, Russian Presidential Academy of National Economy and Public Administration, vol. 5, pages 171-190.
    2. Röttger, Julia & Blümel, Miriam & Linder, Roland & Busse, Reinhard, 2017. "Health system responsiveness and chronic disease care – What is the role of disease management programs? An analysis based on cross-sectional survey and administrative claims data," Social Science & Medicine, Elsevier, vol. 185(C), pages 54-62.
    3. Gianluca Fiorentini & Silvana Robone & Rossella Verzulli, 2018. "How do hospital‐specialty characteristics influence health system responsiveness? An empirical evaluation of in‐patient care in the Italian region of Emilia‐Romagna," Health Economics, John Wiley & Sons, Ltd., vol. 27(2), pages 266-281, February.

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