Comparison of health confidence in rural, suburban and urban areas in the UK and the USA: a secondary analysis

Abstract

ObjectiveConfidence in healthcare may influence the patients’ utilisation of healthcare resources and perceptions of healthcare quality. We sought to determine whether self-reported confidence in healthcare differed between the UK and the USA, as well as by rurality or urbanicity.DesignA secondary analysis of a subset of survey questions regarding self-reported confidence in healthcare from the 2010 Commonwealth Fund International Health Policy Survey.SettingTelephone survey of participants from the UK and the USA.ParticipantsOur final analysis included 1511 UK residents (688 rural, 446 suburban, 372 urban, 5 uncategorised) and 2501 US residents (536 rural, 1294 suburban, 671 urban).Outcome measuresQuestions assessed respondents’ confidence in the effectiveness and affordability of the treatment. We compared survey outcomes from these questions between, and within, the two regions and among, and within, residence types (rural, suburban and urban).ResultsSignificant differences were found in self-reported confidence in healthcare between the UK and US, among residence types, and between the two regions within residence types. Reported levels were higher in the UK. Within regions, significant differences by residence type were found for the US, but not the UK. Within the US, suburban respondents had the highest self-reported confidence in healthcare.ConclusionsSignificant differences exist between the UK and US in confidence in healthcare. In the US, but not in the UK, self-reported confidence is related to residence type. Within countries, significant differences by residence type were found for the US, but not the UK. Our findings warrant the examination of causes for relative confidence levels in healthcare between regions and among US residence types.

Understanding the determinants of public trust in the health care system in China: an analysis of a cross-sectional survey

“…rural or urban area). [4][5][6][7][8] Public trust in the government has also been shown to be related to trust in the health care system. 9,10 Empirical evidence on public trust in health care systems in low-and middle-income countries (LMIC) has been limited and inconclusive.…”

Social factors associated with trust in the health system in northern Sweden: a cross-sectional study

“…However, a multinational study with 31 countries showed opposite results; people living in urban areas showed lower trust in the health system [ 19 ]. Results have been observed in China that are similar to the case of northern Sweden, while no differences between urban and rural areas were reported in the UK [ 23 , 28 ]. Our results are probably context specific to northern Sweden where there are smaller rural municipalities with no hospitals and relatively long distances from healthcare facilities, and where rural citizens experiencing a policy of abandonment by central authorities.…”

Lack of Trust in the Health-Care System After Losing a Child to Suicide

“…Although not specifically studied in suicide-bereaved populations, Haven et al. investigated health confidence in rural, suburban and urban areas in the general population in the US ( n = 2,501) and the UK ( n = 1,511; Haven, Celaya, Pierson, Weisskopf, & Mackinnon, 2013). Health confidence was measured by asking the participants about their confidence in receiving effective treatment and confidence in being able to afford the treatment.…”

“…By contrast, we found no difference between bereaved parents living with a partner and bereaved parents who were widows/widowers. Probably, in conjunction with having raised a psychologically vulnerable child alone, bereaved single parents may have experienced additional stressors such as economic disadvan- Celaya, Pierson, Weisskopf, & Mackinnon, 2013). Health confidence was measured by asking the participants about their confidence in receiving effective treatment and confidence in being able to afford the treatment.…”