The health system responsiveness, defined as non-medical aspect of treatment relating to the protection of the patients’ legitimate rights, is the intrinsic goal of the WHO strategy for 21st century, and is an important index to measure the service ability of medical institutions.

The data were collected in 2016-2017 and consists of the first visits for patients of grass-roots medical institutions. SPSS21.0 was used to complete statistical description and tests including multiple linear regression model analysis and structural equation analysis.

There are differences in perceived responsiveness of primary medical institutions in Qinghai and Zhejiang. Zhejiang residents believe that the primary medical institutions have better medical environment, medical staff have better attitudes to explain problems, treatment plan explanation is more clear, and the attitude toward listening to patient condition is more serious. However, Qinghai residents think that the waiting time of the basic medical institutions is shorter and the degree of trust in the medical staff is higher. There are differences in health system responsiveness among different groups. According to the standard of ɑ=0.05, factors such as ethnicity, household registration type, the medical insurance type, the occupational type, the marital status, the educational level have a significant impact on the perceived responsiveness of primary medical institutions.

Health system responsiveness exists in the region, which may be related to the differences in the economic development level, the state of health service and the management and investment in health services among different regions. On the other hand, residents living in the same area are more similar in terms of living environment, socio-economic status, ideology and culture, and health beliefs than those from different regions. This may be one of the reasons the results of health system responsiveness assessment are closer than for residents in different regions.