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Social Medicine

Trust in provider as a factor influencing health services utilization in Bulgaria

Svetlana Panayotova


Introduction: Trust in the physician affects many important aspects of health behaviors and attitudes, including patients' willingness to seek care, undergo treatment, and adhere to prescribed therapy.

Objective: To investigate and analyze the impact of trust in health service providers on the utilization of outpatient and inpatient medical care in the country.

Material and methods: An online survey was conducted concerning the use of health services (primary, specialist, and hospital) and the degree of trust of respondents in health service providers. Differences in utilization were proven according to the degree of trust in the provider, using a χ2-test of independence. Binary logistic regression was applied to investigate the influence of trust on the use of health services.

Results and discussion: There were 1292 respondents who completed the survey in its entirety. The vast majority of them (82.3%) trust specialist doctors, followed by 74.9% who trust general practitioners and 50.7% who trust hospitals. The share of service users is highest in the categories having a very high level of trust, or rather, trust in the provider. Higher levels of trust have been associated to higher odds of seeing a general practitioner (OR = 1.83; p < 0.001) and higher chances of being hospitalized (OR = 1.31; p < 0.001). Under- or overutilization of health services can result from a lack of trust in the providers.

Conclusion: Trust in providers affects healthcare utilization, and increasing trust can improve efficiency in the sector.


trust in provider of health services, utilization, Bulgaria

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