Trust in Healthcare during COVID-19 in Europe: vulnerable groups trust the least

Abstract

Aim We examined predictors of trust in the healthcare system during the COVID-19 pandemic in 27 European countries. Subjects and methods We used population-based data drawn from the Living, working and COVID-19 survey (N = 21,884, 52% female, ages 18 to 92 years) covering 27 European countries dated June and July 2020. Multilevel linear regression, linear regression, and regression-tree analyses were conducted. Results We found that most participants tended to trust the healthcare system, although a substantial part could still be classified as distrusting (approx. 21%). Multiple variables, including being middle-aged or of older age, being female, lower levels of education, unemployment, worse general health status, having income difficulties, having unmet needs for healthcare, no healthcare contact during the COVID-19 pandemic, higher mental distress, and loneliness, were significantly associated with lower levels of trust. Among these variables mental distress, income difficulties, and unmet needs for healthcare emerged as especially important and, across European regions and countries, consistent predictors for lower trust in the healthcare system during the COVID-19 pandemic. Conclusions Medically vulnerable subgroups, such as individuals with unmet healthcare needs, higher levels of mental distress, and older age, as well as people living in socially and economically vulnerable situations, such as higher levels of loneliness and financial difficulties, were the least trusting of the healthcare system during the COVID-19 pandemic. As these vulnerable subgroups are also at highest risk for contracting COVID-19 and experiencing negative COVID-19-related outcomes, more targeted prevention and intervention efforts should be implemented in these groups.

Differences in Stakeholders’ Perception of the Impact of COVID-19 on Clinical Care and Decision-Making

“…It seems to be intensively influenced by individual perceptions of the pandemic situation and the related consequences [ 5 , 9 ]. The personal reflection of the pandemic consequences appears to be of high relevance since the individual perception of risk guides response and health-related decision-making [ 10 , 11 ]. The evaluation of COVID-19-related risks and decision-making processes mainly focused on prevention and vaccination behaviors [ 12 , 13 ].…”

‘What are you hiding from me?’ A qualitative study exploring health consumer attitudes and experiences regarding the patient‐led recording of a hospital clinical encounter

“…However, prioritizing the integrity of the relationship is an important consideration in the current climate of distrust in the healthcare sector. [40][41][42] Clinicians who regularly refuse recordings may need to both re-examine their practice, consult hospital guidelines as to consumer-clinician rights and consider how to mindfully communicate a refusal if that is still their preference. 3,6,13 Our findings revealed that consumers are not aware of their rights or responsibilities when it comes to recording a clinical encounter.…”

A pyramid model to describe changing decision making under high uncertainty during the COVID-19 pandemic

“…9 Furthermore, decisional uncertainty was identified as important factor determining patients' trust in healthcare during the pandemic. 10 Alternative criteria and frames of reference gain a differentiating importance during decision making with regard to the direct and concrete process organisation. These decisional criteria may even get in conflict with the common normative framework composed of ethical and legal aspects.…”