Differences in the health systems responsiveness in townships with different economic levels, and the role of general practitioners

Abstract Background The evaluation of health system responsiveness (HSR) can improve patient satisfaction, promote health equity and improve the quality of health services. There are many factors affecting HSR, but in view of China's national conditions, economic inequality and the promotion of general practitioners. Our research explored these two aspects. Methods Using a multi-stage stratified sampling method, 820 participants aged 18 and over were extracted in Kunshan City, China. Analysis of Variance was used in preliminary analysis. Linear regression was applied to explore the association of people in different economic towns with HSR score. The moderating effect of general practitioners was analyzed using Model 1 in Macro PROCESS program. Results Among the participants in the study, reported that mean (SD) HSR score was 34.7 ± 4.29. The association between the economic development level of towns and HSR was significant even after adjustment (β = -0.42; 95% Confidence Intervals, CI = -0.69-0.15; p = 0.002). In addition, hospital level (β = 0.75; 95% CI = 0.34–1.15; p < 0.001) and whether general practitioners are contracted (β = 2.61; 95% CI = 1.81–3.41; p < 0.001) were also important factors affecting the HSR score. Moderating effect analysis showed that general practitioners significantly moderated the effect of economic level on HSR score (P = 0.01). Conclusions Economic development level of towns was negatively correlated with the increase of HSR score. People in towns with good economic development level may have lower HSR scores. At the same time, general practitioners moderated the impact of economic development level on HSR score.