ABSTRACT:Introduction: The responsiveness of the healthcare system is its quality or ability to respond to the legitimate expectations of the population about those aspects of their interaction with the system that do not directly contribute to health. The focus on responsiveness reflects the aspirations of states to enhance the public welfare by providing healthcare systems that respond to people’s needs and preferences and treat them with respect. Aim: The study aims to design and test a Bulgarian instrument for the measurement of the healthcare system’s responsiveness. Materials and Methods: International publications of healthcare system frameworks and studies of responsiveness were searched and reviewed. Over 450 items from responsiveness instruments were identified and evaluated, and new ones were also constructed. 74 candidate items were selected for evaluation by an expert panel with regard to their content validity. The resulting items were tested in pilot survey study. Results: 43 suitable items were established covering all aspects of responsiveness. The items demonstrated good psychometric properties. Conclusion: The responsiveness of the healthcare system contributes to a betterment of individual welfare regardless of health improvement, while also increasing public trust in the healthcare system, service use, compliance, and the adaptivity of the system to the changing needs of consumers. It is important to measure systematically and reliably the responsiveness of the Bulgarian healthcare system. This developing instrument can be useful for that purpose.

Keywords: healthcare system, responsiveness, assessment, instrument

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