Trust in the Health System: The Case of Cardiology Patients in Turkey

This paper studies trust in the health system via survey data collected for a sample of 231 cardiology patients residing in three public hospitals in the Mersin province, Turkey. The paper uses a diversity of statistical methods for inference and testing. These include factor analysis, clustering techniques, and Markov transition probability matrices. Four central results of the paper are the following: First, demographic and socioeconomic factors, i.e., age, sex, marital status, education, and economic status, are not related with trust in the health system. Second, patients exhibiting higher levels of general interpersonal trust and higher levels of satisfaction from healthcare services have higher levels of trust in the health system. Third, interpersonal trust in nurses and physicians is strongly and positively related with impersonal trust in hospitals and the Ministry of Health. Finally, trust and distrust in the health system exhibit remarkable persistence from past to present in both interpersonally and impersonally. These results contribute to our understanding of trust building and erosion in the health system in the context of a developing country that has experienced a systemic transformation in the recent decade