Responsiveness of Health Systems : A Barometer of the Quality of Health Services

In the health field, quality is a complex and multidimensional variable. The complexity is shown by different levels of quality, which provide a global picture of the performance of a health system: compliance with mandatory rules, compliance with professional recommendations/references, action of steady improvement aiming at resolving health problems, risk management or excellence seeking, etc. The multidimensional character is provided by various dimensions to be covered by evaluation indicators of the performance of a health system: acceptability in what points the health system meets our expectations; accessibility knowing whether we can receive the services where and when we need them; adequacy knowing whether the care meets our needs and is based on established rules; competence knowing whether knowledge and skills of health services providers are consistent with the care they provide; continuity matching services – coordination, integration, easy access; effectiveness concerning the services in operation and in what point they influence our health; efficiency achieving best results at the lowest cost; security minimizing possible risks in a health area or service. Out of these dimensions – which, from a synergetic perspective, define the overall performance of a health system – we retain for a detailed analysis only those concerning acceptability, adequacy and competence, which determine the responsiveness to the patients’ expectations. Moreover, for working out a methodology for assessing the quality of health services, it is necessary to analyse various standard procedures for assessing the performance of health services initiated and rendered by international organisations and promoted, first of all, by the World Health Organisation. Our paper also deals with actions already taken worldwide, which now are undergoing structural improvements as well as with opportunities for making market surveys (opinion polls) among the beneficiaries of a health system: the citizens