University of Montenegro, Faculty of Economics, Podgorica, Montenegro.
University of Split, Faculty of Economics, Business and Tourism, Split, Croatia.
PLoS One. 2022 Sep 8;17(9):e0274318. doi: 10.1371/journal.pone.0274318. eCollection 2022.
In this paper, we analyze the influence of corruption perception, experiences of corruptive behavior, and healthcare autonomy on the public trust in Montenegrin healthcare, by surveying the general population before and after the global COVID-19 pandemic. By providing a quasi-replication of a previous empirical study of corruption and trust in the Croatian public healthcare sector, we introduce the COVID-19 pandemic as a new research context. Before the pandemic, we found a consistent and significant negative influence of the corruptive practices and the generally perceived level of corruption (corruption salience) on the trust in public healthcare. The emergence of COVID-19 had mixed effects: while there is a slightly higher effect of corruption salience to the preference of public healthcare, corruptive experiences still matter but are tolerated much higher than before the pandemic. Public assessment of the autonomy of the health system increases preference for public healthcare, both before and after the pandemic, although the emergence of COVID-19 somewhat lowers this effect. The obtained results point to the most significant challenges of the 'post-COVID-19' social context to public health policymaking and management of public healthcare institutions. These include focusing the public healthcare reforms on corruption, reducing waiting times for different diagnostics and medical procedures in the public healthcare system, and regulating the 'dual practice' (simultaneous work in public and private healthcare institutions).
本文通过在全球 COVID-19 大流行前后对普通人群进行调查，分析了腐败感知、腐败行为经历以及医疗自主权对黑山公众对医疗保健信任的影响。通过对克罗地亚公共医疗保健部门腐败和信任的先前实证研究进行准复制，我们将 COVID-19 大流行引入新的研究背景。在大流行之前，我们发现腐败行为和普遍感知的腐败水平（腐败凸显）对公众对公共医疗保健的信任有一致且显著的负面影响。COVID-19 的出现产生了混合影响：虽然腐败凸显对公共医疗保健的偏好有更高的影响，但腐败行为的影响仍然存在，但比大流行前容忍度更高。公众对卫生系统自主权的评估增加了对公共医疗保健的偏好，无论是在大流行之前还是之后，尽管 COVID-19 的出现略微降低了这种影响。研究结果指出了“后 COVID-19”社会背景对公共卫生政策制定和公共医疗机构管理的最大挑战。这些挑战包括将公共医疗保健改革的重点放在腐败问题上、减少公共医疗保健系统中不同诊断和医疗程序的等待时间，以及规范“双重实践”（同时在公共和私营医疗机构工作）。
