A Research on The Relationship Between Trust in Physician and Hospital and Hospital Preference

Abstract

The aim of the study is to determine the relationship between the level of trust in physicians and hospitals of patients applying to health institutions and the factors that are effective in hospital preference. In order to collect data in the study, data were collected from patients who came to two hospitals, one public and one private, to receive outpatient services. In the study, convenience sampling method was used as sample selection and data were obtained from 436 participants. A questionnaire form consisting of four sections was used to collect data. The sections of the questionnaire are; socio-demographic information form, two parts of the patient's trust in physician and hospital scale as trust in physician and trust in hospital, and finally the factors affecting hospital preference scale. Before the data analysis, reliability analyses of the scales were performed and found to be reliable for analysis. SPSS 25 package programme was used for data analysis. Since the data did not show normal distribution, Independent Sampels test and Spearman Correlation test from nonparametric methods were applied. As a result of the analyses, a statistically significant relationship was found between trust in physicians and the staff attitude and behaviour dimension of hospital preference. A statistically significant relationship was found between trust in hospital and consumer cost dimension of hospital preference. In addition, a moderate positive relationship was found between trust in hospital and trust in physician. The results of the difference analysis of socio-demographic characteristics are as follows; trust in physician was found to be significantly related to hospital type variable; trust in hospital was found to be significantly related to gender variable; and four dimensions of hospital preference were found to be significantly related to gender, marital status, age, hospital type and occupation variables. In the light of the findings, it is concluded that hospitals should give importance to the staff attitude and behaviour dimension of hospital preference in order to increase trust in physicians and to the consumer cost dimension of hospital preference in order to increase trust in hospitals. In addition, the most effective factor in hospital preference is service quality. As a result, significant relationships were found between trust in physician and hospital and hospital preference factors.

Keywords

• Trust
• Trust in Physician
• Trust in Hospital
• Hospital Preference

References

1. Adaman, F. I. K., Ardic, O. P., Erus, B., & Tüzemen, D. I. D. (2009). Hospital choice: survey evidence from Istanbul. Turkish Studies, 10(3), 443-468.
2. Akıncı F, Yilmaz F, Sezgin FE (2005). Sağlık hizmetlerinde hasta beklentilerinin karşılanması. Hacettepe Sağlık İdaresi Dergisi, 8(1): 1–19.
3. Alaszewski A (2003). Risk, trust and health. Health, Risk & Society, 5(3): 235–239.
4. Al-Doghaither, A. H., Abdelrhman, B. M., Saeed, A. W., & Magzoub, M. E. M. A. (2003). Factors influencing patient choice of hospitals in Riyadh, Saudi Arabia. The journal of the Royal Society for the Promotion of Health, 123(2), 105-109.
5. Aloba, O., Mapayi, B., Akinsulore, S., Ukpong, D., & Fatoye, O. (2014). Trust in Physician Scale: Factor structure, reliability, validity and correlates of trust in a sample of Nigerian psychiatric outpatients. Asian Journal of Psychiatry, 11, 20-27.
6. Ateş, M., Erbaydar, T., Demirkıran, K., Özhan, G., Cevahir, E., & İşçi̇, E. (2004). Gebze Halkının Sağlık Hizmetlerini Kullanımı ve Sağlık Kuruluşlarını Tercih Etme Nedenlerinin Belirlenmesine Yönelik Bir Araştırma. Hacettepe Sağlık İdaresi Dergisi, 7(3), 319-341.
7. Aytekin A (2016). Hasta memnuniyeti ve sadakati ilişkisi üzerine bir araştırma. Yüksek Lisans Tezi, Hacettepe Üniversitesi, Ankara.
8. Bachinger, S. M., Kolk, A. M., & Smets, E. M. (2009). Patients’ trust in their physician—Psychometric properties of the Dutch version of the “Wake Forest Physician Trust Scale”. Patient Education and Counseling, 76(1), 126-131.

9. Bahadori, M., Teymourzadeh, E., Ravangard, R., Nasiri, A., Raadabadi, M., & Alimohammadzadeh, K. (2016). Factors contributing towards patient's choice of a hospital clinic from the patients' and managers' perspective. Electronic Physician, 8(5), 2378-2387.
10. Balkrishnan, R., Hall, M. A., Blackwelder, S., & Bradley, D. (2004). Trust in insurers and access to physicians: associated enrollee behaviors and changes over time. Health Services Research, 39(4), 813-824.
11. Banerjee, A., & Sanyal, D. (2012). Dynamics of Doctor-Patient Relationship: A Cross-Sectional Study on Concordance, Trust, and Patient Enablement. Journal of Family & Community Medicine, 19(1), 12-19.
12. Birk H.O. & Henriksen L.O. (2012). Which Factors Decided General Practitioners’ Choice of Hospital on Behalf of Their Patients in an Area with Free Choice of Public Hospital? A Questionnaire Study. BMC Health Services Research, 12(126), 1-10.
13. Bozkurt, Ö. Ü. İ. (2020). Hastaların Bilgi İhtiyacının Memnuniyet ve Sadakate Etkisinde Güven Düzeyinin Ilımlaştırıcı Etkisi (Gaziantep Örneği). Journal Of Institute Of Economic Development And Social Researches, 6(24), 562-580.
14. Brown C, Carroll M, Pauly K (2015). Patient-centered care: An overview of definitions and concepts. Health Care Management Review, 40(2): 117–125.
15. Burke CS, Sims DE, Lazzara EH, Salas E (2007). Trust in leadership: A multi-level review and integration. The Leadership Quarterly, 18(6): 606–632.
16. Büyüköztürk, Ş., Çakmak, E. K., Akgün, Ö. E., Karadeniz, Ş., & Demirel, F. (2015). Bilimsel araştırma yöntemleri (25. Baskı). Ankara: Pegem Atıf İndeksi.
17. Calnan M, Rowe R (2004). Trust relations in health care: The new agenda. European Journal of Public Health, 14(1): 4–6.
18. Campos-Castillo, C. (2019). Exploring skin color and black-white differences in trust in physicians in a cross-sectional study of US adults. Journal of the National Medical Association, 111(4), 393-406.
19. Chernew M., Scanlon D. & Hayward R. (1998). Insurance Type and Choice of Hospital for Coronary Artery Bypass Graft Surgery. Health Services Research, 33(3), 447-466.
20. Çiftçi G. E. (2010). Sağlık Hizmetleri Pazarlamasında Konumlandırma Stratejileri: Kırıkkale İli Örneği. (Yayınlanmamış Yüksek Lisans Tezi). Gazi Üniversitesi, Ankara.
21. Çobanoğlu N (2009). Hasta hakları ve etik. Güneş Kitabevi, Ankara.
22. Coşkun, R., Altunışık, R. & Yıldırım, E. (2017). Sosyal bilimlerde araştırma yöntemleri: SPSS uygulamalı. Sakarya: Sakarya Yayıncılık.
23. Croker, J. E., Swancutt, D. R., Roberts, M. J., Abel, G. A., Roland, M., & Campbell, J. L. (2013). Factors affecting patients' trust and confidence in GPs: evidence from the English national GP patient survey. BMJ Open, 3(5).
24. Egede, L. E., & Ellis, C. (2008). Development and testing of the multidimensional trust in health care systems scale. Journal of General Internal Medicine, 23(6), 808-815.
25. Egunjobi L. (1983). Factors Influencing Choice of Hospitals: A Case Study of the Northern part of Oyo State, Nigeria. Social Science & Medicine, 17(9), 585–589.
26. Erdem Ş. (2007). Sağlık Hizmetleri Pazarlaması: Hastaların Sunulan Hizmetlerin Kalitesini Algılamaları Üzerine Bir Uygulama. (Yayınlanmamış Yüksek Lisans Tezi). Trakya Üniversitesi, Edirne.
27. Goold, S. D. (2001). Trust and the ethics of health care institutions. Hastings Center Report, 31(6), 26-33.
28. Gopichandran V (2013). Trust in healthcare in India: Overcoming barriers. Journal of Postgraduate Medicine, 59(2): 82–83.
29. Gopichandran, V., & Chetlapalli, S. K. (2013). Dimensions and Determinants of Trust in Health Care in Resource Poor Settings–A Qualitative Exploration. PLOS ONE, 8(7), 1-8.
30. Gordon, H. S., Pugach, O., Berbaum, M. L., & Ford, M. E. (2014). Examining patients’ trust in physicians and the VA healthcare system in a prospective cohort followed for six-months after an exacerbation of heart failure. Patient Education and Counseling, 97(2), 173-179.
31. Gülcemal H, Keklik B (2016). Sağlık hizmeti sunumunda güvenin önemi. Journal of Health and Society, 26(1): 64–75.
32. Güzeldemir D (2006). Diş hekimliği hizmetlerinde hasta güveni ve ilişkisel etik. Hacettepe Diş Hekimliği Fakültesi Dergisi, 30(1): 37–43.
33. Hall MA, Zheng B, Dugan E, Camacho F, Kidd KE, Mishra A, Balkrishnan R (2001). Measuring patients’ trust in their primary care providers. Medical Care Research and Review, 59(3): 293–318.
34. Hall, M. A., Camacho, F., Dugan, E., & Balkrishnan, R. (2002). Trust in the medical profession: conceptual and measurement issues. Health Services Research, 37(5), 1419-1439.
35. Heischmidt KA, Heischmidt BR (1991). Factors influencing rural hospital patronage. Health Marketing Quarterly, 8(3-4): 5–17.
36. Hoşgör, H., & Hoşgör, D. G. (2019). Hastaların Hastane Seçimini Etkileyen Faktörler: Sistematik Derleme (1996-2017). Hacettepe Sağlık İdaresi Dergisi, 22(2), 437-456.
37. Işık, O., Erişen, M., & Fidan, C. (2016). Tüketicilerin hastane seçiminde etki eden faktörlere ilişkin algılamaları. İşletme Bilimi Dergisi, 4(1), 99-110.
38. Isroliwala S., Wainwright C. & Sehdev K. (2004). A Local View of Factors Influencing Patient Choice. Cranfield University Healthcare Management Research Group Enterprise Integration, UK.
39. Jones L. & Mays N. (2009) Systematic Review of the Impact of Patient Choice of Provider in the English NHS. London School of Hygiene and Tropical Medicine 1-26.
40. Jones, D. E., Carson, K. A., Bleich, S. N., & Cooper, L. A. (2012). Patient trust in physicians and adoption of lifestyle behaviors to control high blood pressure. Patient education and counseling, 89(1), 57-62.
41. Jung, K., Feldman, R., & Scanlon, D. (2011). Where would you go for your next hospitalization?. Journal of health economics, 30(4), 832-841.
42. Kamra V., Singh H. & De K. K. (2016) Factors Affecting Hospital Choice Decisions: An Exploratory Study of Healthcare Consumers in Northern India. Asia Pacific Journal of Health Management 11(1), 76-84.
43. Kao, A. C., Green, D. C., Davis, N. A., Koplan, J. P., & Cleary, P. D. (1998). Patients’ trust in their physicians: effects of choice, continuity, and payment method. Journal of general internal medicine, 13(10), 681-686.
44. Karagöz, Y. (2014). SPSS 21.1 Uygulamalı Biyoistatistik. Ankara: Nobel Yayınları.
45. Karagöz, Y. (2016). SPSS 23 ve AMOS 23 uygulamalı istatistiksel analizler. Nobel Akademik Yayıncılık.
46. Karahan A, Torun F, Ünal S (2016). Hasta merkezli sağlık hizmetleri ve tercih nedenleri. Sağlık ve Toplum Dergisi, 26(2): 297–305.
47. Karsavuran, S., Kaya, S., & Akturan, S. (2011). Trust in patient-physician communication: A survey in a general surgery policlinic. Hacettepe Sağlık İdaresi Dergisi, 14, 185-212.
48. Kemp, E., Ravi, J., & Becerra, E. (2014). Healthcare branding: developing emotionally based consumer brand relationships. Journal of Services Marketing, 28, 126 - 137.
49. Kılıç, S. (2016). Cronbach'ın alfa güvenirlik katsayısı. Journal of Mood Disorders, 6(1), 47-48.
50. Kirk, R. E. (2008). Statistics: An Introduction (Fifth Edition). United States: Thomson Higher Education.
51. Kobayashi M., Mano T. and Yamauchi K. (2013) Patients’ Preference on Selecting a Medical Institution. International Journal of Health Care Quality Assurance 26(4), 341–352.
52. Kuhlmann E (2006). Modernising health care: Reinventing professions, the state and the public. Policy Press.
53. Kulkarni P, Kulkarni A, Gaiha S (2019). Exploring patient trust in doctors in India: A qualitative approach. BMJ Global Health, 4(5): e001601.
54. Laugharne R, Priebe S, McCabe R, Garland N, Clifford D (2012). Trust, choice and power in mental health: A literature review. Social Psychiatry and Psychiatric Epidemiology, 47(4): 487–494.
55. LaVeist, T. A., Nickerson, K. J., & Bowie, J. V. (2000). Attitudes About Racism, Medical Mistrust, and Satisfaction With Care Among African American and White Cardiac Patients. Medical care research and review: MCRR, 57, 146-161.
56. Lee M. J. (2018) Factor Affecting the Korean Customer’s Choice of Hospitals. Journal of Engineering and Applied Sciences 13(2), 2889-2892.
57. LoCurto, J., & Berg, G. M. (2016). Trust in healthcare settings: Scale development, methods, and preliminary determinants. SAGE Open Medicine, 1-12.
58. Lu, L. Y., Sheikholeslami, N., Alokozai, A., Eppler, S. L., & Kamal, R. N. (2019). The role of patient research in patient trust in their physician. The Journal of hand surgery, 44(7), 617-e1.
59. Mainous AG, Baker R, Love MM, Gray DP, Gill JM (2001). Continuity of care and trust in one’s physician. Family Medicine, 33(1): 22–27.
60. Moscelli G, Siciliani L, Gutacker N, Gravelle H (2016). Location, quality and choice of hospital: Evidence from England 2002–2013. Regional Science and Urban Economics, 60: 112–124.
61. Mwaseba S. L., Mwang’onda E. S. & Juma M. S. (2018) Patient’s Perception on Factors for Choice of Healthcare Delivery at Public Hospitals in Dodoma City. Central African Journal of Public Health 4(3), 76-80.
62. Naoui, F. B., & Zaiem, I. (2010). The impact of relationship quality on client's loyalty: An application in the parapharmaceutical industry. International Journal of Pharmaceutical and Healthcare Marketing, 4(2), 137-156.
63. Ozawa, S. (2010). Trust Matters: Villagers' Trust in Providers and Insurers in the Context of a Community-based Health Insurance Scheme in Cambodia. (Yayınlanmamış, Doktora Tezi). Johns Hopkins University.
64. Platonova, E. A., Kennedy, K. N., & Shewchuk, R. M. (2008). Understanding patient satisfaction, trust, and loyalty to primary care physicians. Medical Care Research and Review, 65(6), 696-712.
65. Prang K. H., Canaway R., Bismark M., Dunt D., Miller J.A. & Kelaher M. (2018) Public Performance Reporting and Hospital Choice: A Cross-Sectional Study of Patients Undergoing Cancer Surgery in the Australian Private Healthcare Sector. BMJ Open 8(4), 1-9.
66. Rădoi M, Lupu D (2014). Trust in health systems: A comparison between private and public institutions in Romania. Revista Economica, 66(1): 64–71.
67. Roberts MJ (2007). Getting health reform right: A guide to improving performance and equity. Oxford University Press.
68. Rowe R, Calnan M (2006). Trust relations in health care–the new agenda. European Journal of Public Health, 16(1): 4–6.
69. Safran DG, Taira DA, Rogers WH, Kosinski M, Ware JE, Tarlov AR (2000). Linking primary care performance to outcomes of care. Journal of Family Practice, 49(2): 123–130.
70. Şantaş, F., Kurşun, A., & Ahmet, K. A. R. (2016). Hastane tercihine etki eden faktörler: Sağlık hizmetleri pazarlaması perspektifinden alan araştırması. Hacettepe Sağlık İdaresi Dergisi, 19(1), 17-33.
71. Shah, J., & Dickinson, C. L. (2010). Establishing which factors patients value when selecting urology outpatient care. British Journal of Medical and Surgical Urology, 3(1), 25-29.
72. Simon, M. A., Zhang, M., & Dong, X. (2014). Trust in physicians among US chinese older adults. The Journals of gerontology. Series A, Biological Sciences and Medical Sciences, 69, 46-53.
73. Straten GFM, Friele RD, Groenewegen PP (2002). Public trust in Dutch health care. Social Science & Medicine, 55(2): 227–234.
74. Tabachnick, B. G., & Fidell, L. S. (2013). Using multivariate statistics (Sixth edition). United States: Pearson Education.
75. Tam, W. (2012). Health care reform and patients' trust in physicians in urban Beijing. The China Quarterly, 827-843.
76. Tang, L. (2011). The influences of patient's trust in medical service and attitude towards health policy on patient's overall satisfaction with medical service and sub satisfaction in China. BMC Public Health, 11(1), 1-8.
77. Tengilimoğlu D (2001). Sağlık işletmeciliği. Siyasal Kitabevi, Ankara.
78. Thom DH, Hall MA, Pawlson LG (2002). Measuring patients’ trust in physicians when assessing quality of care. Health Affairs, 21(4): 124–132.
79. Thom, D. H., & Campbell, B. (1997). Patient-physician trust: an exploratory study. The Journal of family practice, 44(2), 169-176.
80. Tüfekçi N. & Asığbulmuş H. (2016) The Factors that Effective in the Choice of Hospital and Patient Satisfaction: The Sample of Isparta. Journal of Current Researches on Health Sector 6(2), 71-92.
81. Türk Dil Kurumu (2023). Güven. https://sozluk.gov.tr/
82. Yıldırım A, Kaya A, Gözübüyük B (2009). Sağlık kurumlarında güven ve hasta sadakati ilişkisi. İşletme Araştırmaları Dergisi, 1(1): 12–20.
83. Yıldırım Kaptanoğlu, A. (2010). Sağlık Hizmeti Alanların Başvurdukları Hastaneye Ve Hekime Duyduğu Güven Duygusunun Araştırılması. (Yayınlanmamış, Doktora Tezi). Marmara Üniversitesi/Sağlık Bilimleri Enstitüsü, İstanbul.
84. Yılmaz, S., & Akkaya, V. B. (2009). Hekim ile Dermatoloji Hastalari Arasindaki Iliskide Güven Unsurunun Ölçülmesi/Measuring Trust Component in Patient-Physician Relationship in Dermatology. Turkderm, 43(3), 89-94.
85. Zarei, E., Daneshkohan, A., Khabiri, R., & Arab, M. (2015). The effect of hospital service quality on patient's trust. Iranian Red Crescent Medical Journal, 17(1), e17505-e17505.
86. Zhao, D. H., Rao, K. Q., & Zhang, Z. R. (2016). Patient trust in physicians: Empirical evidence from Shanghai, China. Chinese Medical Journal, 129(7), 814–818.
87. Zheng Y, Hui C, Yang D (2017). Hospital trust and patient satisfaction: A cross-level analysis. Health Marketing Quarterly, 34(3): 213–228.