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What does it mean to trust a health system?: A qualitative study of Canadian health care values

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  • Abelson, Julia
  • Miller, Fiona A.
  • Giacomini, Mita

Abstract

Objectives We used a qualitative empirical study of Canadians' values toward their health system to develop more meaningful conceptualizations of trust and health systems that can inform the pursuit of more trustworthy health systems.Methods We convened nine focus groups in three Canadian cities in 2002 and 2004 in conjunction with a national public opinion telephone survey of Canadians' attitudes and values toward their health system. Health system trust emerged as a significant theme in focus group discussions and was investigated using a modified grounded theory approach.Findings Respondents construct cleavages and alliances to position themselves in relation to different features of the trusted health system. The health system and Canadian Medicare are identified sources of trust just as are individual health care providers. Core to the trust relationship is the experience of vulnerability which provides the impetus for placing trust (in providers, governments and health systems) or seeds distrust, mistrust and resilience in the same.Conclusions We offer a more robust conceptualization of what it means to trust a health system. Policy maker efforts to intervene to restore lost trust could usefully be informed by these findings.

Suggested Citation

  • Abelson, Julia & Miller, Fiona A. & Giacomini, Mita, 2009. "What does it mean to trust a health system?: A qualitative study of Canadian health care values," Health Policy, Elsevier, vol. 91(1), pages 63-70, June.
    • Handle: RePEc:eee:hepoli:v:91:y:2009:i:1:p:63-70
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    References listed on IDEAS

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    1. Gilson, Lucy, 2005. "Editorial: building trust and value in health systems in low- and middle-income countries," Social Science & Medicine, Elsevier, vol. 61(7), pages 1381-1384, October.
    2. Goold, Susan Dorr & Klipp, Glenn, 2002. "Managed care members talk about trust," Social Science & Medicine, Elsevier, vol. 54(6), pages 879-888, March.
    3. Gilson, Lucy, 2003. "Trust and the development of health care as a social institution," Social Science & Medicine, Elsevier, vol. 56(7), pages 1453-1468, April.
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    3. Hunter, P.V. & Ward, H.A. & Puurveen, G., 2023. "Trust as a key measure of quality and safety after the restriction of family contact in Canadian long-term care settings during the COVID-19 pandemic," Health Policy, Elsevier, vol. 128(C), pages 18-27.
    4. Grignon Michel, 2012. "Roadblocks to Reform: Beyond the Usual Suspects," Centre for Health Economics and Policy Analysis Working Paper Series 2012-01, Centre for Health Economics and Policy Analysis (CHEPA), McMaster University, Hamilton, Canada.
    5. Dahai Zhao & Hongyu Zhao & Paul D. Cleary, 2019. "International variations in trust in health care systems," International Journal of Health Planning and Management, Wiley Blackwell, vol. 34(1), pages 130-139, January.
    6. Bombard, Yvonne & Abelson, Julia & Simeonov, Dorina & Gauvin, Francois-Pierre, 2011. "Eliciting ethical and social values in health technology assessment: A participatory approach," Social Science & Medicine, Elsevier, vol. 73(1), pages 135-144, July.
    7. Groenewegen, Peter P. & Hansen, Johan & de Jong, Judith D., 2019. "Trust in times of health reform," Health Policy, Elsevier, vol. 123(3), pages 281-287.
    8. Kruk, Margaret E. & Freedman, Lynn P. & Anglin, Grace A. & Waldman, Ronald J., 2010. "Rebuilding health systems to improve health and promote statebuilding in post-conflict countries: A theoretical framework and research agenda," Social Science & Medicine, Elsevier, vol. 70(1), pages 89-97, January.
    9. Mauro ROMANELLI, 2017. "Towards Sustainable Health Care Organizations," Management Dynamics in the Knowledge Economy, College of Management, National University of Political Studies and Public Administration, vol. 5(3), pages 377-394, September.

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