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Trust in the healthcare system and mortality : A population-based prospective cohort study in southern Sweden

Lindström, Martin LU and Pirouzifard, Mirnabi LU (2022) In SSM - Population Health 18.
Abstract

Aims: To investigate associations between trust in the healthcare system and all-cause, cardiovascular, cancer and other causes mortality. Study design: Prospective cohort study. Methods: A public health questionnaire was conducted in 2008 in Scania, the southernmost part of Sweden, with a 54.1% participation rate with a postal questionnaire and three reminders. In this study 24,833 respondents were included. The baseline questionnaire study was linked to prospective 8.3-year follow-up cause-specific mortality register data. Survival (Cox) regression analyses were conducted. Results: A 15.2% proportion of respondents reported very high, 59.1% rather high, and 21.7% not particularly high trust in the healthcare system, while 3.2%... (More)

Aims: To investigate associations between trust in the healthcare system and all-cause, cardiovascular, cancer and other causes mortality. Study design: Prospective cohort study. Methods: A public health questionnaire was conducted in 2008 in Scania, the southernmost part of Sweden, with a 54.1% participation rate with a postal questionnaire and three reminders. In this study 24,833 respondents were included. The baseline questionnaire study was linked to prospective 8.3-year follow-up cause-specific mortality register data. Survival (Cox) regression analyses were conducted. Results: A 15.2% proportion of respondents reported very high, 59.1% rather high, and 21.7% not particularly high trust in the healthcare system, while 3.2% reported no trust at all and 0.9% did not know. The groups with rather high and not particularly high trust in the healthcare system had significantly lower all-cause mortality than the reference group with very high trust in the healthcare system. These statistically significant results remained throughout the multiple analyses, and were explained by lower cancer mortality in both the rather high and not particularly high trust respondent groups, and lower cardiovascular mortality in the not particularly high trust respondent group. No significant results were observed in the adjusted models for other causes mortality. No significant results were observed for the no trust and don't know categories in the multiple adjusted models, but these groups are small. Conclusions: The results suggest a comparative advantage of moderate trust compared to very high trust in this setting of long waiting times for cancer and CVD treatment.

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author
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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Cancer mortality, Cardiovascular mortality, Generalized trust in other people, Health-related behaviors, Mortality, Social capital, Sweden, Trust in the healthcare system
in
SSM - Population Health
volume
18
article number
101109
publisher
Elsevier
external identifiers
  • pmid:35535209
  • scopus:85129237449
ISSN
2352-8273
DOI
10.1016/j.ssmph.2022.101109
language
English
LU publication?
yes
additional info
Publisher Copyright: © 2022 The Authors
id
7437c84c-9d38-4fda-9f18-b1d3ff08b374
date added to LUP
2022-07-06 14:42:24
date last changed
2024-03-21 04:51:46
@article{7437c84c-9d38-4fda-9f18-b1d3ff08b374,
  abstract     = {{<p>Aims: To investigate associations between trust in the healthcare system and all-cause, cardiovascular, cancer and other causes mortality. Study design: Prospective cohort study. Methods: A public health questionnaire was conducted in 2008 in Scania, the southernmost part of Sweden, with a 54.1% participation rate with a postal questionnaire and three reminders. In this study 24,833 respondents were included. The baseline questionnaire study was linked to prospective 8.3-year follow-up cause-specific mortality register data. Survival (Cox) regression analyses were conducted. Results: A 15.2% proportion of respondents reported very high, 59.1% rather high, and 21.7% not particularly high trust in the healthcare system, while 3.2% reported no trust at all and 0.9% did not know. The groups with rather high and not particularly high trust in the healthcare system had significantly lower all-cause mortality than the reference group with very high trust in the healthcare system. These statistically significant results remained throughout the multiple analyses, and were explained by lower cancer mortality in both the rather high and not particularly high trust respondent groups, and lower cardiovascular mortality in the not particularly high trust respondent group. No significant results were observed in the adjusted models for other causes mortality. No significant results were observed for the no trust and don't know categories in the multiple adjusted models, but these groups are small. Conclusions: The results suggest a comparative advantage of moderate trust compared to very high trust in this setting of long waiting times for cancer and CVD treatment.</p>}},
  author       = {{Lindström, Martin and Pirouzifard, Mirnabi}},
  issn         = {{2352-8273}},
  keywords     = {{Cancer mortality; Cardiovascular mortality; Generalized trust in other people; Health-related behaviors; Mortality; Social capital; Sweden; Trust in the healthcare system}},
  language     = {{eng}},
  publisher    = {{Elsevier}},
  series       = {{SSM - Population Health}},
  title        = {{Trust in the healthcare system and mortality : A population-based prospective cohort study in southern Sweden}},
  url          = {{http://dx.doi.org/10.1016/j.ssmph.2022.101109}},
  doi          = {{10.1016/j.ssmph.2022.101109}},
  volume       = {{18}},
  year         = {{2022}},
}