Balkrishnan Rajesh, Dugan Elizabeth, Camacho Fabian T, Hall Mark A
Department of Management and Policy Sciences, University of Texas, School of Public Health, Houston, Texas 77225, USA.
Med Care. 2003 Sep;41(9):1058-64. doi: 10.1097/01.MLR.0000083743.15238.9F.
Conceptual or theoretical analysts of trust in medical settings distinguish among markedly different objects or types of trust. However, little is known about how similar or different these types of trust are in reality and the relationship of trust with satisfaction.
This exploratory study conducted a comparison among trust in one's personal physician, health insurer, and in the medical profession, and examined whether the relationship between trust and satisfaction differs according to the type of trust in question.
Random national telephone survey using validated multi-item measures of trust and satisfaction.
A total of 1117 individuals aged 20 years and older with health insurance and reporting 2 healthcare professional visits in the past 2 years.
Rank-order correlation analyses find that both physician and insurer trust are sensitive to the amount of contact the patient has had and their adequacy of choice in selecting the physician or insurer. Trust in the medical profession stands out as being uniquely related to patients' desire to seek care and their preference for how much control physicians should have in making medical decisions. Adding satisfaction to the models reduced the number of significant predictors of insurance trust disproportionately.
Consistent with theory, we found both substantial similarities and notable differences in the sets of factors that predict 3 different types of trust. Trust and satisfaction are much less distinct with respect to health insurers than with respect to physicians or the medical profession.
医疗环境中信任的概念性或理论性分析家区分出了明显不同的信任对象或类型。然而，对于这些类型的信任在现实中究竟有多相似或不同，以及信任与满意度之间的关系，我们却知之甚少。
这项探索性研究对个人对医生、健康保险公司以及医疗行业的信任进行了比较，并考察了信任与满意度之间的关系是否因所讨论的信任类型而异。
采用经过验证的多项目信任和满意度测量方法进行全国随机电话调查。
共有1117名年龄在20岁及以上、拥有医疗保险且在过去两年中报告有两次医疗专业就诊经历的个体。
等级相关分析发现，对医生和保险公司的信任都对患者的接触量以及他们在选择医生或保险公司时的选择充分性敏感。对医疗行业的信任突出表现为与患者寻求医疗护理的愿望以及他们对医生在做出医疗决策时应拥有多少控制权的偏好独特相关。在模型中加入满意度后，保险信任的显著预测因素数量不成比例地减少。
与理论一致，我们发现预测三种不同类型信任的因素集既有实质性的相似之处，也有显著的差异。与医生或医疗行业相比，健康保险公司方面的信任和满意度之间的区别要小得多。
