Does distrust in providers affect health-care utilization in China?

Duckett, J. , Hunt, K. , Munro, N. and Sutton, M. (2016) Does distrust in providers affect health-care utilization in China? Health Policy and Planning, 31(8), pp. 1001-1009. (doi: 10.1093/heapol/czw024) (PMID:27117483) (PMCID:PMC5013779)

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How trust affects health-care utilization is not well-understood, especially in low- and middle- income countries. This article focuses on China, a middle-income country where low trust in health-care settings has become a prominent issue, but actual levels of distrust and their implications for utilization are unknown. We conducted a nationally representative survey of the Chinese population (November 2012 to January 2013), which resulted in a sample of 3680 adult men and women. Respondents rated their trust in different types of health-care providers. Using multivariate logistic and negative binomial regression models, we estimated the association between distrust in clinics and respondents’ hospital visits in the last year; whether they had sought hospital treatment first for two common symptoms (headache, cold) in the last 2 months; and whether they said they would go first to a hospital if they had a minor or major illness. We analysed these associations before and after adjusting for performance evaluations of clinics and hospitals, controlling for sex, age, education, income, insurance status, household registration and self-assessed health. We found that distrust in hospitals is low, but distrust in clinics is high and strongly associated with increased hospital utilization, especially for minor symptoms and illnesses. Further research is needed to understand the reasons for distrust in clinics because its effects are not fully accounted for by poor evaluations of their competence.

Item Type:Articles
Glasgow Author(s) Enlighten ID:Hunt, Professor Kathryn and Munro, Dr Neil and Duckett, Professor Jane
Authors: Duckett, J., Hunt, K., Munro, N., and Sutton, M.
College/School:College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > MRC/CSO SPHSU
College of Social Sciences > School of Social and Political Sciences > Politics
Journal Name:Health Policy and Planning
Publisher:Oxford University Press
ISSN (Online):1460-2237
Published Online:26 April 2016
Copyright Holders:Copyright © 2016 The Authors
First Published:First published in Health Policy and Planning 31(8): 1001-1009
Publisher Policy:Reproduced under a Creative Commons License

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
567651Performance evaluations, trust and utilization of health care in China: understanding relationships between attitudes and health-related behaviourJane DuckettEconomic & Social Research Council (ESRC)ES/J011487/1SPS - POLITICS