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

Area of Science:

• Health Services Research
• Health Economics
• Sociology of Health

Background:

• Understanding healthcare utilization is crucial, especially in low- and middle-income countries.
• Low trust in healthcare settings is a growing concern in China, yet its impact on service use remains unclear.

Purpose of the Study:

• To investigate the relationship between distrust in healthcare providers and healthcare utilization patterns in China.
• To determine if distrust in clinics influences hospital visits and symptom-related healthcare seeking behaviors.

Main Methods:

• Nationally representative survey of 3680 Chinese adults (Nov 2012 - Jan 2013).
• Multivariate logistic and negative binomial regression models were used to analyze the association between distrust and hospital utilization.
• Analyses were adjusted for provider performance evaluations and demographic/socioeconomic factors.

Main Results:

• Distrust in hospitals was found to be low, while distrust in clinics was high.
• High distrust in clinics was significantly associated with increased hospital utilization, especially for minor symptoms and illnesses.
• These associations persisted even after accounting for performance evaluations and controlling for various covariates.

Conclusions:

• Distrust in primary care clinics is a significant driver of increased hospital utilization in China.
• The findings highlight the need for further research into the root causes of clinic distrust, as it is not solely explained by perceived competence.
• Addressing distrust in clinics may be essential for optimizing healthcare resource allocation and improving patient access to appropriate care levels.