ABSTRACT

This article examines how public trust in physicians varies across two primary dimensions: trust in physicians' technical competence and in their fiduciary duty to prioritise patients' interests above their own. While prior empirical studies explain variations in trust of physicians primarily by focusing on patients' individual characteristics, trust differences across national borders remain underexplored. This study utilises nationally representative survey data from 26 countries and data from national-level collections to investigate the correlates of both dimensions of trust. Multilevel ordinal logistic regression analysis reveals associations between the two dimensions of trust in physicians and a host of individual and national characteristics. The study reveals a complex relationship between trust and how countries fund health care delivery. Trust that physicians uphold their fiduciary duty to patients is significantly stronger in countries with predominantly tax-funded primary care systems. Conversely, both fiduciary trust and competence trust are weaker where out-of-pocket payments comprise a greater percentage of total health spending. Finally, individuals who report they are in better health are more likely to trust physicians.

摘要

本文研究了公众对医生的信任如何在两个主要方面变化：对医生的技术能力的信任以及对患者的利益优先于其自身的信托义务。尽管先前的实证研究主要通过关注患者的个人特征来解释医师信任度的差异，但跨国界的信任度差异仍未得到充分研究。这项研究利用了来自26个国家的具有国家代表性的调查数据和来自国家级馆藏的数据来调查信任的两个方面的相互关系。多级序数逻辑回归分析揭示了医师信任的两个维度与许多个人和国家特征之间的关联。该研究揭示了信任与国家如何为医疗服务提供资金之间的复杂关系。在主要由税收资助的初级保健系统的国家中，相信医生对患者履行其信托义务的意愿明显增强。相反，在自付费用占卫生总支出的比例较高的情况下，信托信任和能力信任都较弱。最后，报告自己健康状况良好的人更可能信任医生。