Comparison of Responsiveness Status of Rehabilitation Services Organization From the Perspective of Services Recipients

Responsiveness is a process that all organizations, such as hospitals and rehabilitation centers, need to implement it in order to legitimize their activities; and on the other hand, the recipients of rehabilitation services as a citizen of the community have a special place. Therefore, the main purpose of this study was to determine and compare the response status of rehabilitation service providers from the perspective of people with disabilities (PWD) and their families in Tehran in 2016.

The study is descriptive-analytical and cross-sectional. The statistical population of the study consisted of all people with disabilities and their families who received rehabilitation services (Red Crescent, Wellbeing, Private Sector) in 2017. Samples were collected from rehabilitation centers of 5 districts of Tehran, using available sampling. The questionnaire was distributed based on the Response Questionnaire (World Health Organization, 2000) and 357 samples were collected. Adults with physical and motor disabilities and families with children with physical disabilities were included in the study, as well as those with mental disabilities and those who did not wish to participate in the study, as well as incomplete and unread questionnaires. The questionnaire has eight domains and included 25 questions. The questionnaire was distributed among 11 rehabilitation specialists with CVI=0.91 and the reliability of the questionnaire was confirmed by 30 questionnaires in four centers in two weeks with a correlation coefficient of 0.83 and Cronbach's alpha of 0.77. Data were analyzed through descriptive statistics (mean and standard deviation) and inferential statistics (Mann-Whitney and Kruskal-Wallis) by using SPSS V. 22.

The results showed that the age of the majority of patients (49.6%) was in the group of 30-39 years. Depending on the type of center, the mean age included 49.5% in private centers, 49.5% in the welfare centers, and 50% in Red Crescent. The highest responsiveness was related to the dimensions of the right to choose and environmental quality (2.6 and 2.41 out of 5, respectively) in private centers, environmental quality (2.1 out of 5) in welfare centers, and then, right to choose had the highest score. The lowest accountability was reported for dignity (2.18 out of 5). The mean scores of social support dimensions in the three types of center were statistically different (P=0.001), as well as the mean scores of immediate attention (P=0.002), participation in decision-making (P=0.009), confidentiality (P=0.010), and total responsiveness (P=0.04) there was a statistically significant difference between the two groups of referral type and mean scores of immediate attention dimensions in the two sex groups (P=0.022). However, the mean scores of total responsiveness dimensions in marital status (P=0.446) and type of insurance (P=0.535) were not statistically significant.

The findings of this study displayed that responsibility as a criterion of quality of rehabilitation services, in fact, provides a clear picture of the clients’ performance. Responsibility of welfare centers was better than private and Red Crescent Centers. In this study, rehabilitation centers had the lowest performance in areas of transparent communication, dignity, and social support which may result in lower dignity which may indicate less attention to the dignity of the recipient of the service and the deficiency of insufficient insurance coverage to support rehabilitation services. While these dimensions of responsiveness are important for services recipients. Therefore, it is necessary to respond to the rehabilitation system in these areas (transparent communication, dignity and social protection). Also, it is recommended further studies in the area of responsiveness of rehabilitation system.