Abstract
BackgroundTrust in health care has been intensely researched in resource rich settings. Some studies in resource poor settings suggest that the dimensions and determinants of trust are likely to be different.ObjectivesThis study was done as a qualitative exploration of the dimensions and determinants of trust in health care in Tamil Nadu, a state in south India to assess the differences from dimensions and determinants in resource rich settings.MethodologyThe participants included people belonging to marginalized communities with poor access to health care services and living in conditions of resource deprivation. A total of thirty five in depth interviews were conducted. The interviews were summarized and transcribed and data were analyzed following thematic analysis and grounded theory approach.ResultsThe key dimensions of trust in health care identified during the interviews were perceived competence, assurance of treatment irrespective of ability to pay or at any time of the day, patients’ willingness to accept drawbacks in health care, loyalty to the physician and respect for the physician. Comfort with the physician and health facility, personal involvement of the doctor with the patient, behavior and approach of doctor, economic factors, and health awareness were identified as factors determining the levels of trust in health care.ConclusionsThe dimensions and determinants of trust in health care in resource poor settings are different from that in resource rich settings. There is a need to develop scales to measure trust in health care in resource poor settings using these specific dimensions and determinants.
Highlights
Trust is an essential attribute of all human social interactions. [1] A basic level of trust is important for any transaction between human beings
The dimensions and determinants of trust in health care are represented in the conceptual table 1
The lesser health awareness, and lesser access to information leads to highly subjective assessments of competence as compared to resourcerich settings where the higher levels of health literacy and access to information helps people make objective assessments
Summary
Trust is an essential attribute of all human social interactions. [1] A basic level of trust is important for any transaction between human beings. Vulnerability, power differential and exploitation are involved in the concept of trust in health care.[3,4,5] Trust in health care is usually defined as a set of expectations that the patient has from the doctor and the health care system to help them heal. This set of expectations includes appropriate diagnosis, correct treatment, non-exploitation, genuine interest in the welfare of the patient and transparent disclosure of all information. Some studies in resource poor settings suggest that the dimensions and determinants of trust are likely to be different
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
