Please use this identifier to cite or link to this item:
Appears in Collections:Faculty of Health Sciences and Sport Journal Articles
Peer Review Status: Refereed
Title: Does distrust in providers affect health-care utilization in China?
Author(s): Duckett, Jane
Hunt, Kate
Munro, Neil
Sutton, Matt
Keywords: Trust
utilization of health services
Issue Date: Oct-2016
Date Deposited: 11-Apr-2018
Citation: Duckett J, Hunt K, Munro N & Sutton M (2016) Does distrust in providers affect health-care utilization in China?. Health Policy and Planning, 31 (8), pp. 1001-1009.
Abstract: How trust affects health-care utilization is not well-understood, especially in low- and middle-income countries. This article focuses on China, a middle-income country where low trust in health-care settings has become a prominent issue, but actual levels of distrust and their implications for utilization are unknown. We conducted a nationally representative survey of the Chinese population (November 2012 to January 2013), which resulted in a sample of 3680 adult men and women. Respondents rated their trust in different types of health-care providers. Using multivariate logistic and negative binomial regression models, we estimated the association between distrust in clinics and respondents' hospital visits in the last year; whether they had sought hospital treatment first for two common symptoms (headache, cold) in the last 2 months; and whether they said they would go first to a hospital if they had a minor or major illness. We analysed these associations before and after adjusting for performance evaluations of clinics and hospitals, controlling for sex, age, education, income, insurance status, household registration and self-assessed health. We found that distrust in hospitals is low, but distrust in clinics is high and strongly associated with increased hospital utilization, especially for minor symptoms and illnesses. Further research is needed to understand the reasons for distrust in clinics because its effects are not fully accounted for by poor evaluations of their competence. © 2016 The Author 2016. Published by Oxford University Press. All rights reserved.
DOI Link: 10.1093/heapol/czw024
Rights: © The Author 2016. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
Licence URL(s):

Files in This Item:
File Description SizeFormat 
HealthPolicyPlan.-2016-Duckett-heapol_czw024.pdfFulltext - Published Version269.38 kBAdobe PDFView/Open

This item is protected by original copyright

A file in this item is licensed under a Creative Commons License Creative Commons

Items in the Repository are protected by copyright, with all rights reserved, unless otherwise indicated.

The metadata of the records in the Repository are available under the CC0 public domain dedication: No Rights Reserved

If you believe that any material held in STORRE infringes copyright, please contact providing details and we will remove the Work from public display in STORRE and investigate your claim.