Van der Schee Evelien, Groenewegen Peter P, Friele Roland D
Netherlands Institute for Health Services Research, Utrecht, The Netherlands.
J Health Organ Manag. 2006;20(5):468-76. doi: 10.1108/14777260610701821.
If public trust in health care is to be used as a performance indicator for health care systems, its measurement has to be sensitive to changes in the health care system. For this purpose, this study has monitored public trust in health care in The Netherlands over an eight-year period, from 1997 to 2004. The study expected to find a decrease in public trust, with a low point in 2002.
DESIGN/METHODOLOGY/APPROACH: Since 1997, public trust in health care was measured through postal questionnaires to the "health care consumer panel". This panel consists of approximately 1500 households and forms a representative sample of the Dutch population.
Trust in health care and trust in hospitals did not show any significant trend. Trust in medical specialists displayed an upward trend. Trust in future health care, trust in five out of six dimensions of health care and trust in general practitioners actually did show a decrease. However, only for trust in macro level policies and trust in professional expertise this trend continued. For the remaining trust objects, after 1999 or 2000, an upward trend set in.
RESEARCH IMPLICATIONS/LIMITATIONS: No support was found for our overall assumption. Explanations for the fact that trust did increase after 1999 or 2000 are difficult to find. On the basis of these findings the study questions whether the measure of public trust is sensitive enough to provide information on the performance of the health care system.
ORIGINALITY/VALUE: The aim of this research is to study public trust in health care on its abilities to be used as a performance indicator for health care systems.
若要将公众对医疗保健的信任作为医疗保健系统的一项绩效指标,其测量必须对医疗保健系统的变化保持敏感。为此,本研究在1997年至2004年的八年期间监测了荷兰公众对医疗保健的信任情况。该研究预计会发现公众信任度下降,在2002年达到最低点。
设计/方法/途径:自1997年以来,通过向“医疗保健消费者小组”邮寄问卷来测量公众对医疗保健的信任。该小组由大约1500个家庭组成,构成了荷兰人口的代表性样本。
对医疗保健的信任和对医院的信任未显示出任何显著趋势。对医学专家的信任呈上升趋势。对未来医疗保健的信任、对医疗保健六个维度中五个维度的信任以及对全科医生的信任实际上确实出现了下降。然而,只有对宏观层面政策的信任和对专业知识的信任这一趋势持续存在。对于其余的信任对象,在1999年或2000年之后,出现了上升趋势。
研究启示/局限性:未找到支持我们总体假设的依据。很难找到1999年或2000年之后信任度确实上升这一事实的解释。基于这些发现,该研究质疑公众信任度的衡量是否足够敏感,以提供有关医疗保健系统绩效的信息。
原创性/价值:本研究的目的是研究公众对医疗保健的信任作为医疗保健系统绩效指标的能力。