Abstract
Background and aims: Public health policies and programs should be adapted to the level of public trust in the healthcare system, as an indicator of the public support level. Accordingly, the data about public trust level in the healthcare system is considered as a critical requirement for managing public health crises. This study aimed to rapidly assess the public trust in the healthcare system during the COVID-19 epidemic in Iran, as well as to evaluate the effect of socioeconomic status (SES) on this trust. Methods: This cross-sectional and web-based study which was conducted in Iran during the COVID-19 epidemic included adults aged 18-60 years. A probability proportional to size multistage random sampling was applied and performed in 15 provinces of the country. Data on the main sources of information about COVID-19, trust in healthcare system, fear level of COVID-19, and demographics were collected via an electronic questionnaire. Multiple linear regression was applied, and adjusted regression coefficients and 95% confidence intervals (CIs) were estimated. Results: A total of 5250 adults (response rate: 76%) were included in the study. The mean of reported trust scores was 50.3±22.8, and that of fear scores was 72.0±17.8. The highest (65%) and lowest (28%) levels of trust were observed among participants from the lowest and highest SES, respectively. Gender (male) (P=0.006), higher levels of education (P<0.001), higher socio-economic status (P<0.001), and higher fear scores (P<0.001) were independently correlated with the lower level of ⦰ trust in healthcare system. Conclusion: It was found that the public trust in Iran’s healthcare system was not high enough at the time of the COVID-19 epidemic in the country, especially among higher social class population.
Highlights
Public trust in healthcare system of a country is a critical requirement for handling the public health crises, such as the COVID-19 pandemic.[1]
We need people to be in a psychological state – a state called public trust in the healthcare system, in which the values of the healthcare system are similar to those of the public, appropriate capabilities are possessed to deal with the crisis, and the best services are available to actively serve the public.[9]
As for the gender of participants, 50.5% (n = 2653) of them were female with a mean age of 38.9 ± 12.5 years, and 49.5% (n = 2598) of them were male with a mean age of 39.2 ± 12.5 years
Summary
Public trust in healthcare system of a country is a critical requirement for handling the public health crises, such as the COVID-19 pandemic.[1] A healthcare system usually faces at least two serious challenges at the time of a public health crisis: one is the uncertainty caused by the lack of evidence; and the other one is the high number of destructive rumors being propagated.[2]. This study aimed to rapidly assess the public trust in the healthcare system during the COVID-19 epidemic in Iran, as well as to evaluate the effect of socioeconomic status (SES) on this trust. Conclusion: It was found that the public trust in Iran’s healthcare system was not high enough at the time of the COVID-19 epidemic in the country, especially among higher social class population.
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