Multilevel model for influencing factors of health system responsiveness in Henan province

Objective To investigate the influencing factors of health system responsiveness in Henan province.Methods By multi-stage stratified cluster random sampling technique,3 000 residents aged over 18 years were sampled from 16 cities of Henan province,of which,1 311 residents who received service in medical clinics during past 12 months and fulfilled a questionnaire on health system responsiveness were investigated.Scores of health system responsiveness were calculated with factor analysis.Two level variance component model with level one for individual and level two for city was used for the influencing factors of health system responsiveness.Results There was a regional cluster in health system responsiveness(χ²=5.76,P=0.016).Four kinds of population(with older age of 60-69 years,frequent alcohol drinking,having slight difficulties in social activities,having outpatient insurance) reported lowevaluations for the responsiveness with the β values of 0.231,0.086,0.119,and 0.488,respectively(P < 0.05 for Wald test).Conclusion The main influencing factors of health system responsiveness in Henan province were regional difference and vulnerable populations.Accurate estimation of its influencing factors could be got by two level variance component model.