Two dimensions of trust in physicians in OECD-countries

Arttu Saarinen, Pekka Räsänen & Antti Kouvo


Purpose: This comparative study’s purpose is to analyse citizens’ trust in physicians in 22 OECD-countries.

Design/methodology/approach: We measure trust in physicians using items on generalised and particularised trust. Individual level data are received from the International Social Survey Program (ISSP), 2011. We also utilise macro variables drawn from different data banks. Data were analysed using descriptive statistics and xtlogit regression models. The main micro-level hypothesis is that low self-reported health is strongly associated with lower trust in physicians. Our second micro-level hypothesis is that frequent meetings with physicians result in higher trust. The third micro-level hypothesis assumes that males, and older and better educated respondents, express higher trust compared to others. The first macro-level hypothesis is that lower income inequality leads to higher the trust in physicians. The second macro-level hypothesis is that greater physician density leads to higher trust in physicians.

Findings: We found that the influence of individual and macro level characteristics varies between trust types. Results indicate that both trust types are clearly associated with individual level determinants. However, only general trust in physicians has weak associations with macro level indicators (mainly physician density) and therefore on institutional cross-country differences. It seems that particularised trust in a physician’s skills is more restricted to the individuals’ health and their own experiences meeting doctors, whereas general trust likely reflects attitudes towards the prevalent profession in the country.

Originality/value: Our findings hold significance for healthcare systems research and for research concerning social trust generally.

 Keywords: Physician, Trust, Citizen, Comparative research, Healthcare