Sağlık Bakım Sistemine Duyulan Güven Düzeyinin Belirlenmesi

Abstract

Bu çalışmanın amacı, Türk toplumunun sağlık bakım sistemine duyduğu güven düzeyini belirlemektir. Araştırmanın evrenini Türkiye’de yaşayan 20-74 yaş aralığındaki bireyler oluşturmuş ve online form aracılığıyla 1020 kişiye ulaşılmıştır. Veri; Sosyodemografik Özellikler Formu ve Sağlık Bakım Sistemine Çok Boyutlu Güven Ölçeği aracılığıyla toplanmıştır. Katılımcıların ölçek puan ortalaması 56,32±10,65 olup orta düzeydedir. Sağlık bakım sistemine güven düzeyi; eğitim düzeyi, gelir durumu, düzenli olarak doktor kontrolüne gitme durumu ve sağlık çalışanı yakını bulunma değişkenlerine göre istatistiksel olarak anlamlı farklılıklar göstermektedir. Politika yapıcıların, güvenin oluşmasına ve sürdürülmesine katkı sağlayan bu ve benzeri araştırmalarda belirlenen çeşitli faktörleri inceleyerek etkili stratejiler geliştirmesi önerilmektedir. Bu kapsamda özellikle sağlık hizmetinin kalitesi ve hasta hakları alanlarında iyileştirme yapılmasının güven üzerinde olumlu etki yaratacağı düşünülmektedir. Sağlık hizmeti kullanımı deneyimi arttıkça sağlık sistemine güven düzeyinin de arttığı dikkate alındığında sağlık hizmetlerine erişim üzerinde etkili olan sağlıkta eşitsizliğe ilişkin ekonomik ve sosyal faktörlerin tespiti ve bu kapsamda iyileştirme yapılması, güven düzeyi zaman içerisinde değişiklik gösterebileceği için toplumun sağlık bakım sistemine güven düzeyinin belirli aralıklarla ölçülmesi önerilmektedir.

Keywords

• Güven
• Sağlık Bakım Sistemleri
• Türkiye.

Determining The Level of Trust in The Healthcare System

Abstract

The aim of this study is to determine the level of trust in the healthcare system among the Turkish population. The study was conducted in Turkey and aimed to gather information from individuals aged between 20 and 74. A total of 1020 participants were surveyed online using a Socio-Demographic Characteristics Form and a Multidimensional Trust Scale for the Healthcare System. The participants' scale score average was 56.32±10.65, indicating a moderate level of trust. The level of trust in the healthcare system showed statistically significant differences based on variables such as education level, income status, regular doctor check-up attendance, and the presence of a healthcare worker in the family. Policymakers are recommended to examine various factors identified in such studies that contribute to the formation and maintenance of trust. By analyzing these factors, effective strategies can be developed to enhance trust in the healthcare system. In this context, it is believed that improvements, particularly in the areas of healthcare quality and patient rights, will have a positive impact on trust. Considering that the level of trust in the healthcare system tends to increase as the experience of using healthcare services increases, it is recommended to identify economic and social factors related to healthcare inequalities that affect access to healthcare services and to make improvements in this regard. As trust levels may change over time, it is suggested to periodically measure the level of trust in the healthcare system within the community.

Keywords

• Trust
• Healthcare Systems
• Türkiye.

References

1. 1. Ozawa, S, Sripad, P, How do you measure trust in the health system? A systematic review of the literature, Social science & medicine, 2013, 91, 10-14.
2. 2. Adam, M. B, Donelson, A, Trust is the engine of change: a conceptual model for trust building in health systems, Systems Research and Behavioral Science, 2022, 39(1), 116-127.
3. 3. Paliszkiewicz, J, Koohang, A, Goluchowski, J, Nord, J. H, Management Trust, Organizational Trust, and Organizational Performance: Advancing and Measuring a Theoretical Model, Management and Production Engineering Review, 2014, 5(1), 32-41.
4. 4. Parsons, T, On the concept of political power, Proceedings of the American philosophical society 1963, 107(3), 232-262.
5. 5. Hosmer, L. T, Trust: The connecting link between organizational theory and philosophical ethics, Academy of management Review, 1995, 20(2), 379-403.
6. 6. Ninković, M, Damnjanović, K, Ilić, S, Structure and Misuse of Women's Trust in the Healthcare System in Serbia, PsyArXiv, 2022.
7. 7. Garrubba, M, Yap, G, Trust in health professionals. Centre for Clinical Effectiveness; Monash Health, Melbourne, Australia, 2019.
8. 8. Müller, E, Zill, J. M, Dirmaier, J, Härter, M, Scholl, I, Assessment of trust in physician: a systematic review of measures, PloS one, 2014, 9(9), e106844.

9. 9. Sato, Y, Aida, J, Tsuboya, T, Shirai, K, Koyama, S, Matsuyama, Y, ... Osaka, K, Generalized and particularized trust for health between urban and rural residents in Japan: A cohort study from the JAGES project, Social Science & Medicine, 2018, 202, 43-53.
10. 10. Stacey, R. E, Dempsey, A, The influence of trust in health care systems on postabortion contraceptive choice, Contraception, 2015, 92(5), 458-462.
11. 11. Gilson, L, Trust and the development of health care as a social institution, Social science & medicine, 2003, 56(7), 1453-1468.
12. 12. Rowe, R, Calnan, M, Trust relations in health care—the new agenda, The European Journal of Public Health, 2006, 16(1), 4-6.
13. 13. Dinç, L, Korkmaz, F, Karabulut, E, A validity and reliability study of the Multidimensional Trust in Health-Care Systems Scale in a Turkish patient population, Social Indicators Research, 2013, 113, 107-120.
14. 14. Russell, S, Treatment-seeking behaviour in urban Sri Lanka: trusting the state, trusting private providers, Social science & medicine, 2005, 61(7), 1396-1407.
15. 15. Thom, D. H, Kravitz, R. L, Bell, R. A, Krupat, E, Azari, R, Patient trust in the physician: relationship to patient requests, Family practice, 2002, 19(5), 476-483.
16. 16. Thom, D. H, Hall, M. A, Pawlson, L. G, Measuring patients’ trust in physicians when assessing quality of care, Health affairs, 2004, 23(4), 124-132.
17. 17. Musa, D, Schulz, R, Harris, R, Silverman, M, Thomas, S. B, Trust in the health care system and the use of preventive health services by older black and white adults, American journal of public health, 2009, 99(7), 1293-1299.
18. 18. Gilbert, T. P, Trust and managerialism: exploring discources of care, Leading Global Nursing Research, 2005, 52(4), 454-463.
19. 19. Nal, M, Türkiye’de Sağlık Hizmetleri Sisteminde Güven, Bandırma Onyedi Eylül Üniversitesi Sağlık Bilimleri ve Araştırma Dergisi, 2021, 3(1), 1-10.
20. 20. Rogala, M, Donesch-Jeżo, E, Various dimensions of trust in the health care system, Emergency Medical Service, 2020, 7(4), 296-305.
21. 21. Egede, L. E, Ellis, C, Development and testing of the multidimensional trust in health care systems scale, Journal of General Internal Medicine, 2008, 23, 808-815.
22. 22. Anand, T. N. (2014). Development and testing of a scale to measure trust on public health care system [Doctoral dissertation]. Sree Chitra Tirunal Institute for Medical Sciences & Technology.
23. 23. Rock, S. (2021). Investigating the Relationship Between Vaccine Hesitancy, Trust in Healthcare Providers, and Demographics Factors [Doctoral dissertation]. Dublin, National College of Ireland.
24. 24. Walton-Williams, H, The trust in health care organizations by health sciences students; Medical University of South Carolina-College of Health Professions, 2014..
25. 25. Nejati, B, Lin, C. C, Aaronson, N. K, Cheng, A. S, Browall, M, Lin, C. Y, ...Pakpour, A. H, Determinants of satisfactory patient communication and shared decision making in patients with multiple myeloma, Psycho‐Oncology, 2019, 28(7), 1490-1497.
26. 26. Rovner, B, Casten, R, Nightingale, G, Leiby, B. E, Kelley, M, Rising, K Emergency Department Use in Black Individuals with Diabetes, Diabetes Spectrum, 2023, 36(4), 391-397
27. 27. Usta, D, Korkmaz, F, Trust levels in the healthcare system of the patients receiving services from tertiary care institutions in Turkey. Cukurova Medical Journal, 2020, 45(3), 860-870.
28. 28. Saygili, M, Numanoglu, R, Trust in the Healthcare System and Social Coronavirus Anxiety; A Study in the Turkish Society, Journal of Basic and Clinical Health Sciences, 2021, 6(2), 194-204.
29. 29. TUİK, Adrese Dayalı Nüfus Kayıt Sistemi Sonuçları, 2020. https://l24.im/h3Rs8. 2021 (Erişim tarihi: 28.04.2023).
30. 30. Büyüköztürk, Ş, Kılıç Çakmak, E, Akgün, Ö.E, Karadeniz Ş, Demirel, F, Bilimsel Araştırma Yöntemleri. Pagem Akademi: Ankara, Türkiye, 2016; pp 96.
31. 31. Usta, D. (2016). Hastaların Sağlık Bakım Sistemine Duydukları Güven [Yüksek Lisans Tezi]. Hacettepe Üniversitesi.
32. 32. Gürbüz, Ş, AMOS ile yapısal eşitlik modellemesi temel ilkeler ve uygulamalı analizler; Seçkin Yayıncılık, Ankara, 2021
33. 33. Yeşiloğlu, H. H. (2021). Sağlık Hizmetleri ve Hemşirelik Bakımına İlişkin Güven [Yüksek Lisans Tezi]. Karabük Üniversitesi.
34. 34. Boulware, L. B, Cooper, L. A, Ratner, L. E, La Veist T. A, Powe, N. R, Race and trust in the health care system, Public Health Reports, 2003, 118(4), 358-365.
35. 35. Calnan, M. W, Sanford E, Public trust in healthcare: the system or the doctor?, Quality and Saffety in Health Care, 2004, 13, 92-97.
36. 36. Ertong, G. (2011). Sağlık Sisteminde Hekim Hasta İlişkisi ve Güven Unsuru [Doktora Tezi]. Ankara Üniversitesi.
37. 37. Deniz, S, Çimen, M, Hekimlere güven düzeyinin belirlenmesine yönelik bir araştırma, Manisa Celal Bayar Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi, 2021, 8(1), 10-16.
38. 38. Li, L, Zhu, L, Zhou, X, Zeng, G, Huang, H, Gan, Y, ...Wu, C, Patients’ trust and associated factors among primary care institutions in China: a cross-sectional study, BMC Primary Care, 2022, 23(1), 1-9.
39. 39. Ertong Attar, G, Trust in the health system: The case of cardiology patients in Turkey, Atatürk Üniversitesi Sosyal Bilimler Enstitüsü Dergisi, 2018, 22(2), 961-976.
40. 40. Gülcemal, E, Keklik, B, Hastaların hekimlere duydukları güveni etkileyen faktörlerin incelenmesine yönelik bir araştırma: Isparta ili örneği, Mehmet Akif Ersoy Üniversitesi Sosyal Bilimler Enstitüsü Dergisi, 2016, 8(14): 64-87.
41. 41. Pearson, S. D, Raeke, L. H, Patients' trust in physicians: many theories, few measures, and little data, Journal of general internal medicine, 2000, 15(7), 509-513.
42. 42. Çelik Yavuz, S. (2020). Hastaların genel hastane hizmetlerinden memnuniyetlerinin ve hemşirelere olan güveninin belirlenmesi [Yüksek Lisans Tezi]. Hacettepe Üniversitesi.
43. 43. Kim, A. M, Bae, J, Kang, S, Kim, Y. Y, Lee, J. S, Patient factors that affect trust in physicians: a cross-sectional study, BMC family practice, 2018, 19(1), 1-8.
44. 44. Han, Y, Lie, R. K, Li, Z, Guo, R, Trust in the Doctor–Patient Relationship in Chinese Public Hospitals: Evidence for Hope, Patient preference and adherence, 2022, 647-657.
45. 45. Bagheri-Lankarani, K, Imanieh, M. H, Hassani, A. H, Vardanjani, H. M, Public trust in health care system in Iran: a rapid assessment during the covid-19 epidemic in Iran, International Journal of Epidemiologic Research, 2021, 4(4), 146-151.
46. 46. Sutherland, B. L, Pecanac, K, LaBorde, T. M, Bartels, C. M, Brennan, M. B, Good working relationships: how healthcare system proximity influences trust between healthcare workers, Journal of interprofessional care, 2022, 36(3), 331-339.
47. 47. Gregory, P. A, Austin, Z, Trust in interprofessional collaboration: Perspectives of pharmacists and physicians, Canadian Pharmacists Journal/Revue des Pharmaciens du Canada, 2016, 149(4), 236-245.
48. 48. Ward, P. R, Rokkas, P, Cenko, C, Pulvirenti, M, Dean, N, Carney, S, ... Meyer, S, A qualitative study of patient (dis) trust in public and private hospitals: the importance of choice and pragmatic acceptance for trust considerations in South Australia, BMC Health Services Research, 2015, 15(1), 1-12.
49. 49. Ozawa, S, Walker, D. G, Trust in the context of community-based health insurance schemes in Cambodia: villagers’ trust in health insurers. In Innovations in health system finance in developing and transitional economies. Emerald Group Publishing Limited, 2009, 21, pp. 107-132.
50. 50. Guo, J, Hernandez, I, Dickson, S, Tang, S, Essien, U. R, Mair, C, Berenbrok, L. A, Income disparities in driving distance to health care infrastructure in the United States: a geographic information systems analysis, BMC Research Notes, 2022, 15(1), 1-4.
51. 51. Caballo, B, Dey, S, Prabhu, P, Seal, B, Chu, P, Kim, L, The effects on socioeconomic status on the quality and accessibility of health care services, Across the Spectrum of Socioeconomics, 2021, 1(4), 1-15.
52. 52. Cao, Q, Krok-Schoen, J. L, Guo, M, Dong, X, Trust in physicians, health insurance, and health care utilization among Chinese older immigrants, Ethnicity & Health, 2022, 1-18.
53. 53. Ostertag, S, Wright, B. R, Broadhead, R. S, Altice, F. L, Trust and other characteristics associated with health care utilization by injection drug users, Journal of Drug Issues, 2006, 36(4), 953-974.
54. 54. Hong, H, Oh, H. J, The effects of patient-centered communication: exploring the mediating role of trust in healthcare providers, Health communication, 2020, 35(4), 502-511.