Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St E8003, Baltimore, MD 21205, USA.
Health Policy Plan. 2011 Jul;26 Suppl 1:i20-9. doi: 10.1093/heapol/czr045.
How trust in providers affects health care-seeking behaviour is not well understood. Focus groups and household surveys were conducted in Cambodia to examine how villagers describe their trust in public and private providers, and to assess whether a difference exists in provider trust levels. Our findings suggest the reasons for trusting public and private providers differ, and that villagers' trust in and relationship with providers is one of the important considerations affecting where they seek care. People believed that public providers were 'honest' and 'sincere', did not 'bad mouth people' and explained the 'status of [the] disease'. Villagers trusted public providers for their skills and abilities, and for an effective referral system. In contrast, respondents noted that seeing private providers was 'comfortable and easy', that they 'come to our home' and patients can 'owe [them] some money'. Private providers were trusted for being very friendly and approachable, extremely thorough and careful, and easy to contact. Among those who sought care in the past 30 days, trust in the health care provider was listed as the fifth and second most important consideration for choosing public or private providers, respectively. This study illustrates the importance of trust as a unique concept that can affect people's choice of health care providers in a low-income country.
人们对提供者的信任如何影响医疗服务的利用尚不清楚。本研究在柬埔寨开展了焦点小组讨论和入户调查，以检验村民如何描述他们对公立和私立提供者的信任，并评估两者的信任水平是否存在差异。研究结果表明，人们信任公立和私立提供者的原因不同，村民对提供者的信任和关系是影响他们就医地点的重要考虑因素之一。人们认为公立提供者“诚实”和“真诚”，不会“说人坏话”，并能解释“疾病的状况”。村民信任公立提供者的技能和能力，以及有效的转诊系统。相比之下，受访者指出，看私立医生“舒适和方便”，因为他们“会到家里来”，而且患者可以“欠他们一些钱”。私立医生非常友好、平易近人，而且极其细致、谨慎，易于联系，这些特点赢得了患者的信任。在过去 30 天内寻求过医疗服务的受访者中，信任被列为选择公立或私立提供者的第五和第二重要考虑因素。本研究说明了信任作为一个独特的概念的重要性，它可能会影响人们在低收入国家选择医疗服务提供者。
