Faculty of Engineering Management, Bialystok University of Technology, 15-351 Bialystok, Poland.
Institute of Economics and Finance, University of Szczecin, 71-101 Szczecin, Poland.
Int J Environ Res Public Health. 2021 Apr 7;18(8):3860. doi: 10.3390/ijerph18083860.
Overconsumption of health care is an ever-present and complex problem in health systems. It is especially significant in countries in transition that assign relatively small budgets to health care. In these circumstances, trust in the health system and its institutions is of utmost importance. Many researchers have studied interpersonal trust. Relatively less attention, however, has been paid to public trust in health systems and its impact on overconsumption. Therefore, this paper seeks to identify and examine the link between public trust and the moral hazard experienced by the patient with regard to health care consumption. Moreover, it explores the mediating role of patient satisfaction and patient non-adherence. For these purposes, quantitative research was conducted based on a representative sample of patients in Poland. Interesting findings were made on the issues examined. Patients were shown not to overconsume health care if they trusted the system and were satisfied with their doctor-patient relationship. On the other hand, nonadherence to medical recommendations was shown to increase overuse of medical services. The present study contributes to the existing knowledge by identifying phenomena on the macro (public trust in health care) and micro (patient satisfaction and non-adherence) scales that modify patient behavior with regard to health care consumption. Our results also provide valuable knowledge for health system policymakers. They can be of benefit in developing communication plans at different levels of local government.
医疗保健过度消费是医疗系统中一个长期存在且复杂的问题。在那些将相对较小预算用于医疗保健的转型国家中,这个问题尤为突出。在这种情况下,对医疗体系及其机构的信任至关重要。许多研究人员已经研究了人际信任。然而,相对较少的注意力被关注到公众对医疗体系的信任及其对过度消费的影响。因此,本文旨在识别和检验公众信任与患者在医疗保健消费方面面临的道德风险之间的联系。此外,还探讨了患者满意度和不遵从医嘱的中介作用。为此,本文基于波兰代表性患者样本进行了定量研究。对所研究的问题进行了有趣的发现。如果患者信任医疗体系并对医患关系感到满意,他们就不会过度消费医疗保健。另一方面,不遵守医疗建议被证明会增加医疗服务的过度使用。本研究通过识别宏观(公众对医疗保健的信任)和微观(患者满意度和不遵从医嘱)层面上的现象,为现有知识做出了贡献,这些现象改变了患者在医疗保健消费方面的行为。我们的研究结果也为医疗体系政策制定者提供了有价值的知识。这些结果有助于制定地方政府不同层面的沟通计划。