Measuring the performance of health systems has become a key tool in aiding decision makers to describe, analyze, compare and ultimately improve the delivery and outcomes achieved by a system. The World Health Organization’s (WHO) framework for assessing performance includes three intrinsic goals of health systems, namely health improvement, fairness in financial contribution and responsiveness to user preferences. Broadly speaking health system responsiveness can be defined as the way in which individuals are treated and the environment in which they are treated, encompassing the notion of patient experience. Perhaps the most ambitious attempt to implement a cross-country comparative instrument aimed at measuring health system performance is the World Health Survey (WHS). The modules on responsiveness and health ask respondents to rate their experiences using a 5-point categorical scale (e.g. “very good” to “very bad”). [Extr. abstract] The purpose of this paper is to explore the utility of using information from vignettes to adjust self-reports of health system responsiveness to assess the level of reporting heterogeneity, its impact on responsiveness outcomes and the ability to adjust these to achieve cross-population comparability. We illustrate the use of the methods by exploring information on vignettes from the World Health Survey on the three countries: Mexico, India and the Philippines. While ultimately one would wish to adjust reports of responsiveness to aid cross-country comparison, our ambitions for this paper are more modest and we illustrate the methods across socioeconomic groups within countries only. [Introduction, p. 3]