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Mistrust May Cause People to Put Off Treatment

But delaying needed care ends up raising health-care costs, study says

THURSDAY, Sept. 3 (HealthDay News) -- Patients who don't trust the health-care system are more likely to postpone treatment, potentially hurting their own health and raising overall health care costs, a new study suggests.

Researchers surveyed 401 Baltimore residents, the majority of whom were black, about their attitudes toward the health care system, including doctors, hospitals and insurance companies.

The survey found that people who doubted the trustworthiness of the medical care system were more likely to ignore medical advice, neglect to go to follow-up appointments or to fill prescriptions. Patients who were suspicious of the system were also more likely to admit to putting off medical care that doctors told them was necessary.

The study will appear online in Health Services Research.

"Over the last 15 years, the health care system has changed, and increasingly patients' interactions are with the system, not just an individual doctor," study author Thomas LaVeist, director of the Hopkins Center for Health Disparities Solutions at the Johns Hopkins Bloomberg School of Public Health, said in a release from the news service.

"We found that persons who were more mistrustful of the health-care system were more likely to delay needed care or postpone receiving care, even when they perceived they needed it," LaVeist said.

"Mistrust of the health-care system leads to patients delaying treatment, so when they do enter into the health-care system, they're encountering the system when they're further along and more expensive and difficult to treat," LaVeist added.

Lack of trust also makes it more likely patients will make accusations of malpractice and will ignore recommended treatment plans, leading to sicker patients and increased costs, LaVeist noted.

Previous research has found racial disparities in levels of mistrust for the health-care system, said Chanita Hughes Halbert, of the Penn Center for Population Health and Health Disparities at the University of Pennsylvania.

"However, as noted by the investigators, they were not able to examine the effects of mistrust on health-care utilization within each racial group," Halbert said in the news release. "Ultimately we need to deal with this trust issue by training providers as well as others who encounter patients. This is a health system problem, and we need to find ways to make patients more trusting of health-care institutions in general. The next step is determining what ways we can engender more trust among patients."

More information

The Kaiser Family Foundation has more on minorities and the health-care system.

-- Jennifer Thomas

SOURCE: Health Service Research, news release, Sept. 1, 2009

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