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Trust and the development of health care as a social institution


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  • Gilson, Lucy
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    Health systems are inherently relational and so many of the most critical challenges for health systems are relationship and behaviour problems. Yet the disciplinary perspectives that underlie traditional health policy analysis offer only limited and partial insights into human behaviour and relationships. The health sector, therefore, has much to learn from the wider literature on behaviour and the factors that influence it. A central feature of recent debates, particularly, but not only, in relation to social capital, is trust and its role in facilitating collective action, that is co-operation among people to achieve common goals. The particular significance of trust is that it offers an alternative approach to the economic individualism that has driven public policy analysis in recent decades. This paper considers what the debates on trust have to offer health policy analysis by exploring the meaning, bases and outcomes of trust, and its relevance to health systems. It, first, presents a synthesis of theoretical perspectives on the notion of trust. Second, it argues both that trust underpins the co-operation within health systems that is necessary to health production, and that a trust-based health system can make an important contribution to building value in society. Finally, five conclusions are drawn for an approach to health policy analysis that takes trust seriously.

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    Article provided by Elsevier in its journal Social Science & Medicine.

    Volume (Year): 56 (2003)
    Issue (Month): 7 (April)
    Pages: 1453-1468

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    Handle: RePEc:eee:socmed:v:56:y:2003:i:7:p:1453-1468

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    Keywords: Trust Social capital Health policy Equity;


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    Cited by:
    1. Thomas Porter & Jane Chuma & Catherine Molyneux, 2009. "Barriers to managing chronic illness among urban households in coastal Kenya," Journal of International Development, John Wiley & Sons, Ltd., vol. 21(2), pages 271-290.
    2. Delavallade, Clara, 2014. "Quality healthcare and health insurance retention: Evidence from a randomized experiment in the Kolkata slums:," IFPRI discussion papers 1352, International Food Policy Research Institute (IFPRI).
    3. Radin, Dagmar, 2013. "Does corruption undermine trust in health care? Results from public opinion polls in Croatia," Social Science & Medicine, Elsevier, vol. 98(C), pages 46-53.
    4. Harris, Magdalena & Rhodes, Tim & Martin, Anthea, 2013. "Taming systems to create enabling environments for HCV treatment: Negotiating trust in the drug and alcohol setting," Social Science & Medicine, Elsevier, vol. 83(C), pages 19-26.
    5. Mbonye, Anthony K. & Bygbjerg, Ib & Magnussen, Pascal, 2007. "Intermittent preventive treatment of malaria in pregnancy: Evaluation of a new delivery approach and the policy implications for malaria control in Uganda," Health Policy, Elsevier, vol. 81(2-3), pages 228-241, May.
    6. Magrath, Priscilla & Nichter, Mark, 2012. "Paying for performance and the social relations of health care provision: An anthropological perspective," Social Science & Medicine, Elsevier, vol. 75(10), pages 1778-1785.
    7. Schottmüller, Christoph, 2013. "Cost incentives for doctors: A double-edged sword," European Economic Review, Elsevier, vol. 61(C), pages 43-58.
    8. Meyer, Samantha B. & Coveney, John & Henderson, Julie & Ward, Paul R. & Taylor, Anne W., 2012. "Reconnecting Australian consumers and producers: Identifying problems of distrust," Food Policy, Elsevier, vol. 37(6), pages 634-640.
    9. Badru Bukenya, 2013. "Are service-delivery NGOs building state capacity in the global South? Experiences from HIV/AIDS programmes in rural Uganda," Brooks World Poverty Institute Working Paper Series esid-022-13, BWPI, The University of Manchester.
    10. Mark R. Montgomery & Paul C. Hewett, 2004. "Urban Poverty and Health in Developing Countries: Household and Neighborhood Effects," Department of Economics Working Papers 04-01, Stony Brook University, Department of Economics.
    11. Katarzyna Krot, 2013. "The Impact of Trust and Stereotypes on the Type of Doctor-Patient Relationship: A Study on Polish Health Care Market," Diversity, Technology, and Innovation for Operational Competitiveness: Proceedings of the 2013 International Conference on Technology Innovation and Industrial Management, ToKnowPress.
    12. French, Martin & Miller, Fiona Alice, 2012. "Leveraging the “living laboratory”: On the emergence of the entrepreneurial hospital," Social Science & Medicine, Elsevier, vol. 75(4), pages 717-724.
    13. Jae-Young Lim & Hyun-Hoon Lee & Yeon-Hee Hwang, 2011. "Trust on doctor, social capital and medical care use of the elderly," The European Journal of Health Economics, Springer, vol. 12(2), pages 175-188, April.
    14. Leyla Dinç & Fatoş Korkmaz & Erdem Karabulut, 2013. "A Validity and Reliability Study of the Multidimensional Trust in Health-Care Systems Scale in a Turkish Patient Population," Social Indicators Research, Springer, vol. 113(1), pages 107-120, August.
    15. 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.
    16. Solbjør, Marit & Skolbekken, John-Arne & Sætnan, Ann Rudinow & Hagen, Anne Irene & Forsmo, Siri, 2012. "Mammography screening and trust: The case of interval breast cancer," Social Science & Medicine, Elsevier, vol. 75(10), pages 1746-1752.
    17. Bloom, Gerald & Wolcott, Sara, 2013. "Building institutions for health and health systems in contexts of rapid change," Social Science & Medicine, Elsevier, vol. 96(C), pages 216-222.
    18. Maureen Mackintosh, 2006. "Commercialisation, inequality and the limits to transition in health care: a Polanyian framework for policy analysis," Journal of International Development, John Wiley & Sons, Ltd., vol. 18(3), pages 393-406.
    19. Vetter, Philipp & Boecker, Klaus, 2012. "Benefits of a single payment system: Case study of Abu Dhabi health system reforms," Health Policy, Elsevier, vol. 108(2), pages 105-114.
    20. Ozawa, Sachiko & Sripad, Pooja, 2013. "How do you measure trust in the health system? A systematic review of the literature," Social Science & Medicine, Elsevier, vol. 91(C), pages 10-14.
    21. Jürgensen, Marte & Sandøy, Ingvild F. & Michelo, Charles & Fylkesnes, Knut & Mwangala, Sheila & Blystad, Astrid, 2013. "The seven Cs of the high acceptability of home-based VCT: Results from a mixed methods approach in Zambia," Social Science & Medicine, Elsevier, vol. 97(C), pages 210-219.


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