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Mistrust in health care system could impact patients' health and health care costs

Published on September 1, 2009 at 12:58 AM · No Comments

Mistrust among patients, providers and insurers could harm patients' health and raise overall health care costs, reports a new study.

"Over the last 15 years, the health care system has changed, and increasingly patients' interactions are with the system, not just an individual doctor. We found that persons who were more mistrustful of the health care system were more likely to delay needed care or postpone receiving care, even when they perceived they needed it," said lead author Thomas LaVeist, Ph.D.

LaVeist is director of the Hopkins Center for Health Disparities Solutions at the Johns Hopkins Bloomberg School of Public Health. The study appears in the latest issue of Health Services Research online.

Using a 17-question phone survey, the researchers asked 401 primarily African-American Baltimore residents about their use and trust of health care services. Patients who had doubts about the provision of medical care were more likely to fail to take medical advice, fail to keep a follow-up medical appointment and fail to fill a prescription. Less-trusting patients also reported that they were more likely to postpone necessary medical care.

"Mistrust of the health care system leads to patients delaying treatment, so when they do enter into the health care system, they're encountering the system when they're further along and more expensive and difficult to treat," LaVeist said.

In addition, distrust of the system increases the likelihood of malpractice and decreases adherence to treatment plans, since these patients might be less likely to follow medical advice. These issues could lead to worse outcomes for patients and increased costs, LaVeist said.

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