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Frontiers of Medicine

ISSN 2095-0217

ISSN 2095-0225(Online)

CN 11-5983/R

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Front. Med.    2019, Vol. 13 Issue (4) : 504-510    https://doi.org/10.1007/s11684-018-0666-4
RESEARCH ARTICLE
Changes in public trust in physicians: empirical evidence from China
Dahai Zhao1, Zhiruo Zhang2()
1. School of International and Public Affairs, Shanghai Jiao Tong University, Shanghai 200030, China
2. School of Public Health, Shanghai Jiao Tong University, Shanghai 200025, China
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Abstract

Studies examining the trends in public trust in physicians have provided a considerable amount of valuable policy implications for policymakers compared with cross-sectional studies on this topic in many countries. This study investigated changes in public trust in physicians in China based on two cross-sectional national surveys conducted in 2011 and 2016 and identified the determinants of these changes. The results indicated 83.4% of respondents in 2011 reported trust or strong trust in physicians in China, which decreased to 64.2% by 2016. The results of ordinal logistic regression demonstrated that public trust in physicians in China had decreased significantly from 2011 to 2016 (P<0.001) after adjusting for other independent variables. Self-reported health status, self-rated happiness, and self-identified social class were all associated positively with public trust in physicians in China. The results also confirmed that decreasing public satisfaction with the most recent treatment experience was the major determinant of decreasing public trust in physicians in China. The findings of this study suggest that decreasing public trust in physicians deserves considerable attention from national policymakers and that improving satisfaction with treatment experiences would be the most effective strategy for enhancing public trust in physicians in China.
Keywords trust in physicians      public trust      physician-patient relationship      health system performance     
Corresponding Author(s): Zhiruo Zhang   
Just Accepted Date: 09 August 2018   Online First Date: 07 September 2018    Issue Date: 02 August 2019
 Cite this article:   
Dahai Zhao,Zhiruo Zhang. Changes in public trust in physicians: empirical evidence from China[J]. Front. Med., 2019, 13(4): 504-510.
 URL:  
https://academic.hep.com.cn/fmd/EN/10.1007/s11684-018-0666-4
https://academic.hep.com.cn/fmd/EN/Y2019/V13/I4/504
Variable 2010 2011 (n = 4586) 2016 (n = 4260)
Value Value Weighted value Value Weighted value
Sex
Male 50.6 45.4 50.5 49.9 50.5
Female 49.4 54.6 49.5 50.1 49.5
Age (year) – 47±16 43±16 37±14 42±15
18–29 25.9 15.8 25.7 35.3 25.7
30–39 20.6 17.7 20.4 27.4 20.4
40–49 22.0 22.4 21.9 16.0 21.9
50– 31.5 44.1 32.0 21.3 32.0
Education
Primary school and below 29.8 36.7 30.3 6.8 30.3
Junior high school 43.6 31.2 43.3 16.2 43.3
High school and professional school 15.4 17.7 15.3 22.8 15.3
College and above 11.2 14.4 11.1 54.1 11.1
Marital status
Others 24.9 20.7 22.4 28.7 18.8
Married 75.1 79.3 77.6 71.3 81.2
Urban or rural dwelling
Outside of urban areas 49.4 42.8 44.5 40.5 35.8
In urban areas 50.6 57.2 55.5 59.5 64.2
Health insurance coverage
No health insurance 5.0 12.9 14.3 8.1 8.4
Private health insurance 5.0 3.7 3.9 8.1 8.5
Public health insurance 90.0 83.4 81.8 83.9 83.0
GDP per capita in each province (10 thousand RMB) – 4±1.9 4±1.7 6±2.8 6±2.7
Tab.1  Characteristics of the demographic variables from the surveys and the national census (%)
Variable 2011 (n= 4586) 2016 (n = 4260)
Trust in physicians 3.82±0.73 3.53±0.81
Strongly disagree 1.0 0.7
Disagree 7.9 14.0
Neither agree nor disagree 7.7 21.1
Agree 74.6 60.2
Strongly agree 8.8 4.0
Self-identified social class 4.14±1.77 4.60±2.24
Range 1–10 1–10
Self-reported health status
Poor 10.0 3.0
Fair 33.8 30.9
Good 21.5 8.6
Very good 25.6 29.3
Excellent 9.0 28.1
Self-rated happiness
Very unhappy 1.7 1.0
Quite unhappy 6.8 3.6
Neither unhappiness nor happiness 11.0 14.9
Quite happy 60.1 55.1
Very happy 20.3 25.5
Frequency of doctor visits
Never 19.6 38.2
Seldom 40.8 43.1
Sometimes 26.6 11.2
Often 11.4 7.1
Very often 1.7 0.4
Satisfaction with the last treatment
Completely dissatisfied 1.0 0.4
Very dissatisfied 2.5 2.7
Fairly dissatisfied 8.2 10.8
Neither satisfied nor dissatisfied 12.6 31.4
Fairly satisfied 63.1 44.0
Very satisfied 10.2 5.2
Completely satisfied 2.4 5.5
Tab.2  Comparison of variables between the surveys in 2011 and 2016 (%)
Coefficient Standard error P 95% confidence interval
Year (2016/2011) −0.880 0.064 <0.001 −1.006 to−0.754
Satisfaction with most recent treatment experience 0.571 0.023 <0.001 0.526 to 0.616
Self-rated happiness 0.174 0.029 <0.001 0.117 to 0.231
Frequency of doctor visits −0.014 0.026 0.599 −0.065 to 0.038
Self-reported health status 0.085 0.021 <0.001 0.044 to 0.126
Self-identified social class 0.050 0.012 <0.001 0.026 to 0.073
Sex −0.016 0.048 0.735 −0.110 to 0.077
Age 0.013 0.002 <0.001 0.010 to 0.016
Marital status −0.044 0.057 0.437 −0.155 to 0.067
Urban or rural dwelling −0.028 0.052 0.587 −0.131 to 0.074
GDP per capita in each province −0.036 0.010 0.001 −0.056 to−0.016
Elementary school and below 0.179 0.095 0.059 −0.007 to 0.364
Junior high school 0.028 0.081 0.728 −0.186 to 0.130
High school and professional school 0.218 0.089 0.015 −0.393 to−0.042
College and above Reference
No health insurance −0.088 0.073 0.230 −0.231 to 0.056
Private health insurance 0.183 0.096 0.056 −0.005 to 0.370
Public health insurance Reference
Tab.3  Ordinal logistic regression for public trust in China’s physicians (n = 8846)
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