How do you measure trust in the health system? A systematic review of the literature

Sachiko Ozawa, Pooja Sripad

Research output: Contribution to journalArticle

Abstract

People's trust in the health system plays a role in explaining one's access to and utilization of medical care, adherence to medications, continuity of care, and even self-reported health status. Yet it is not easy to find trust measures and understand what they are measuring. A systematic review of scales and indices identified 45 measures of trust within the health system with an average of 12 questions each, which quantified levels of trust among various relationships across the health system. Existing evidence was narrow in scope, where half examined the relationship between doctors/nurses and patients, and the majority were designed, tested and validated in the United States. We developed a health systems trust content area framework, where we identified that honesty, communication, confidence and competence were captured frequently in these measures, with less focus on concepts such as fidelity, system trust, confidentiality and fairness. Half of the measures employed a qualitative method in the design of these measures and 33% were pilot tested. Reporting of test-retest reliability and inter-rater reliability were less common. This review identifies a need to develop measurements of trust beyond doctor-patient relationships and outside of U.S. contexts, and strengthen the rigor of existing trust measures. Greater development and use of trust measures in the health system could improve monitoring and evaluation efforts, which may in turn result in better health outcomes.

Original languageEnglish (US)
Pages (from-to)10-14
Number of pages5
JournalSocial Science and Medicine
Volume91
DOIs
StatePublished - Aug 2013

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Health
health
qualitative method
fairness
medical care
health status
literature
Systematic Review
continuity
medication
Continuity of Patient Care
nurse
Medication Adherence
confidence
Confidentiality
utilization
monitoring
Reproducibility of Results
Mental Competency
Health Status

Keywords

  • Confidence
  • Health system
  • Measure
  • Scale
  • Systematic review
  • Trust

ASJC Scopus subject areas

  • Health(social science)
  • History and Philosophy of Science

Cite this

How do you measure trust in the health system? A systematic review of the literature. / Ozawa, Sachiko; Sripad, Pooja.

In: Social Science and Medicine, Vol. 91, 08.2013, p. 10-14.

Research output: Contribution to journalArticle

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