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Public trust in health care: a comparison of Germany, the Netherlands, and England and Wales.

Schee, E. van der, Braun, B., Calnan, M., Schnee, M., Groenewegen, P. Public trust in health care: a comparison of Germany, the Netherlands, and England and Wales. European Journal of Public Health: 2003, 13(4 sup) 78. Abstract. 11th Annual Eupha Meeting 'Globalisation and Health in Europe: Harmonising Public Health Practices'. Rome, Italy, 20-22 November 2003.
Aim: To describe and analyse public trust in health care in three European countries Background: Public trust in the social institutions of modern societies is important for the smooth functioning of society. Data on public trust are regularly collected in the EU for some institutional fields, such as the legal system, but not for the health care field. Trust can be divided in interpersonal and public trust. Public trust is a generalised attitude, influenced by people’s experiences in contacts with health care providers and in its turn influencing how people enter these contacts. Interpersonal trust in health care is an important condition for therapeutic success and compliance. At the public level it is an indicator for support of the health care sector. In this study, we collected information about public trust in health care in Germany, The Netherlands, and England and Wales, using an uniform questionnaire. Methods: The public trust in health care questionnaire was developed by Straten e.a. (2002) and translated into German and English, using a backward-forward procedure. The questionnaire was mailed to: - Consumentenpanel Gezondheidszorg (the Netherlands), 1,500 persons, response 80%. - Gesundheitsmonitor (Germany), 2133 persons, response 71%. - A population sample (England and Wales), 2,489 persons, response 48%. The data were analysed by using scale analysis and regression analysis. Results: In general, people in Germany have less trust in health care, while people in England and Wales have the highest levels of trust. As an example we show the trust that people have in medical specialists and in hospitals. This illustrates also the general finding that people in all three countries place more trust in professionals than in institutes (figure). Conclusions: Hypotheses have been developed, relating levels of public trust in the three countries with cultural differences in placing trust, differences in institutional guarantees for good quality care, and differences in the actual health care situation. These hypotheses will be tested and the results will be presented at the conference. (aut. ref.)
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