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Related Experiment Videos

Managed care members talk about trust.

Susan Dorr Goold1, Glenn Klipp

  • 1Department of Internal Medicine, University of Michigan Medical School, Ann Arbor 48109-0429, USA. sgoold@umich.edu

Social Science & Medicine (1982)
|May 9, 2002
PubMed
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Patient trust in health insurance plans is crucial, often outweighing informed choice due to complexity. Experiences with managed care revealed distinct elements of trust and distrust in providers and institutions.

Area of Science:

  • Health Services Research
  • Medical Sociology
  • Consumer Health Behavior

Background:

  • Informed choice in health insurance is complex, potentially leading to reliance on trust over detailed understanding.
  • Managed care plans present unique challenges for enrollees in navigating choices and expectations.
  • Trust is a significant factor in healthcare decisions, influencing patient-provider and patient-institution relationships.

Purpose of the Study:

  • To explore health insurance enrollees' expectations and experiences in choosing and using managed care plans.
  • To investigate the role of trust and distrust in patient decision-making regarding health insurance.
  • To identify the elements and contexts of trust in physicians, medical professions, hospitals, and health insurance plans.

Main Methods:

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  • Conducted semi-structured interviews with 40 diverse enrollees in managed care plans in Southeast Michigan.
  • Focused analysis on the emergent theme of trust and distrust in healthcare and health insurance discussions.
  • Explored interviewee expectations, experiences, and specific elements of trust in various healthcare entities.

Main Results:

  • Interpersonal trust in physicians involved vulnerability, goodwill, advocacy, competence, and ethics.
  • Trust in health insurance plans was often negative, linked to coverage denials, profit motives, and fiscal competence.
  • Enrollees discussed trust and distrust spontaneously, highlighting distinct elements and contexts for different healthcare relationships.

Conclusions:

  • Trust is a critical, multifaceted component of health insurance choices and experiences.
  • Distrust in health insurance plans is prominent, often related to financial concerns and perceived lack of goodwill.
  • Understanding the nuances of trust is essential for improving patient engagement and satisfaction with managed care.