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Top1. Introduction
The service sector is probably the fastest growing sector. The impact of the service industry on the economy of a country is huge. Healthcare and Hospitals which are organizations directly serving the patients are an important part of the service industry. In India, the healthcare sector is one of the largest service sectors in terms of employment as well as revenue. The sector includes hospitals, clinics, laboratories, diagnostic centres, telemedicine, outsourcing, medical equipment, and devices. The healthcare delivery system has two main categories- public and private. The public sector is controlled by the government and it mainly consists of primary healthcare centres (PHCs). There are very few secondary and tertiary care hospitals in the public sector. On the other hand, the private sector provides most of the secondary, tertiary and quart nary care. Both the public, as well as the private sector, are growing at a brisk pace and providing good services to the patient.
In 2012, India had only 0.7 physicians per 1000 population, well below the OECD average of 3.2 and there were 1.1 nurses per 1000 population in India also much lower than the average of 8.8 in OECD countries. About 75% of children in India were vaccinated against Diphtheria, Tetanus, and Pertussis (DTP) and measles in 2012, less than the coverage in most OECD countries which is close to 100% (IBEF, 2017). Various researchers in the past, Owens, and Batchelor (1996) and Sitzia and Wood (1997), have suggested that the term ‘consumer’ should be used for the patient as the user is not passive and dependent. Carr-Hill (1992) suggested the use of term users rather than the customer as a consumer denotes a group of individuals who can safeguard their rights (OECD, 2014). Due to increasing consumerism and wide choices available, patients’ expectations have changed over time. From the health system, consumers expect that it should treat them with dignity along with making and keeping them healthy, allow them to make decisions about their treatment, provide them clear information with their health care providers and ensure confidentiality of their medical records. These actions of the health system are collectively put as one group within responsiveness, respect for persons (De Silva & Valentine, 2000; Gostin, Hodge, Valentine, &Nygren-Krug, 2002; Murray & Frenk, 2000). Consumers also expect access to social support, prompt attention, choice of care provider and essential amenities of adequate quality. These expectations form another group called client orientation (Murray &Frenk, 1999). Put together respect for persons and client orientation form –Responsiveness, a concept which came up in Annual report of the World Health Organization in 2000 (WHO Report 2000). Responsiveness is concerned about meeting the universal, legitimate non-health expectations of patients.
The seven elements of responsiveness (WHO Report 2000) as defined by WHO are: