Responsiveness of the Health Care System: Findings from the Israeli Component of the World Health Survey

This paper describes the results of a 2003 study of the responsiveness of the Israeli health care system, including an analysis of key differences among population subgroups and selected comparisons with European countries.

Responsiveness is a relatively new concept that has been developed by the World Health Organization (WHO) as one of the key measures of health system performance. It is part of a larger initiative to develop standards for comparing health systems worldwide in order to identify areas for improvement in services and health outcomes.

Responsiveness relates to patients’ experiences with the health system, with a focus on the interpersonal aspects of the care they receive. It comprises the following domains: treatment with dignity, privacy/confidentiality of medical information, patient-physician communication, personal autonomy, prompt attention, access to social support, basic quality of amenities, and choice of provider.

This study is based on the findings from the Israeli component of the WHO’s World Health Survey, which was carried out in over 70 countries. Within Israel, we interviewed a national representative sample of over 1,200 adults. The WHO study is unique in that it uses a new technique – anchoring vignettes – to assess expectation levels. This information can contribute to the interpretation of differences in ratings of health care among population groups and across countries. For example, it examines whether differences in ratings between Arabs and Jews and between high and low income groups are due primarily to real differences in the care experience or to differences in expectations.

The findings will contribute to the interpretation of surveys comparing groups in Israel, such as Arabs and Jews, regarding their reports of the quality of the health services they receive, and will help policymakers and managers utilizing the results of such surveys. In addition, the study has relevance for other multi-ethnic countries, as it is among the first to use health care anchoring vignettes to elucidate inter-group comparisons within a country.

This study was funded by the World Health Organization and by Michael and Andrea Dubroff, Massachusetts, USA.