Trust in insurers and access to physicians: associated enrollee behaviors and changes over time

Health Services Research
Rajesh BalkrishnanDonald Bradley

Abstract

Most studies of trust in the medical arena have focused on trust in physicians rather than trust in health insurers, and have been cross-sectional rather than longitudinal studies. This study examined associations among trust in a managed care insurer, trust in one's primary physician, and subsequent enrollee behaviors relating to source of care. The study also documents changes in trust in the study population following the disclosure of physician incentives. A medium-sized (300,000 member) HMO, located in the southeastern United States. One to two years after baseline, we randomly resurveyed a quarter (n = 558) of the initial study population of a large intervention study designed to measure the impact of disclosing HMO financial incentives on patient trust. This follow-up study was also designed to measure the effects of trust on source of care. Multivariate regression analyses of survey data examined associations between baseline levels of trust and subsequent enrollee behaviors such as using a non-PCP physician without a PCP referral, as well as changes in trust since baseline. High baseline insurer trust was associated with a lower probability of a patient seeking care from a non-PCP physician (OR = 0.55, 95 percent CI: 0...Continue Reading

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Citations

Feb 27, 2008·Journal of General Internal Medicine·Katrina ArmstrongJudy A Shea
Aug 31, 2010·Behaviour & Information Technology·Enid N H MontagueBrian M Kleiner
Jan 11, 2013·The International Journal of Health Planning and Management·Christine J FenengaInge Hutter
Mar 5, 2014·The Cochrane Database of Systematic Reviews·Alix RolfeBrian McKinstry
Aug 2, 2019·Substance Abuse : Official Publication of the Association for Medical Education and Research in Substance Abuse·Joshua D CockroftMary S Dietrich
Aug 26, 2021·BMC Health Services Research·Roman LewandowskiGiuseppe T Cirella

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