Iran Health System Responsiveness in regared to Provision of Physical Rehabilitation: Results of a National Survey

The health system's responsiveness to provision of health services displays the ability of the system to meet the non-medical needs of people. The present study aimed to assess Iran's health system responsiveness in providing rehabilitation for people with disabilities (PWD).

This population-based cross-sectional study included 1537 PWD referring to physical rehabilitation centers in all provinces of Iran by using a multistage cluster sampling method in 2019. A valid self-administrated questionnaire was used for data collection. Stata software (version 14.0) was used for data processing and analysis.

The frequency rate of good responsiveness to meet physical rehabilitation needs was 64.5%. The health system's highest and lowest frequency rates of good responsiveness were related to rapid response (74.5%), independence  and participation in decision-making (52.5). Having basic health insurance coverage (OR=1.97, 95% CI:1.20-3.25), severity of disability (OR=2.02, 95% CI:1.14-3.60), economic status of individuals (OR=2.04, 95% CI:1.17-3.56), and household size (OR=0.82, 95% CI:0.72-0.94) were significant determinants in regard to poor responsiveness of the health system.

To maintain and enhance responsiveness and eliminate inequalities, interventions such as expanding the rehabilitation facilities, holding special skills training courses for rehabilitation-related assistants, general practitioners, and health workers, and also, empowering PWD are recommended. Further studies are also recommended to identify the causes of poor responsiveness and take measures that can make the health system more responsible.