Minority Health Archive

Mistrust of Health Care Organizations Is Associated with Underutilization of Health Services

LaVeist, Thomas A. and Isaac, Lydia A. and Williams, Karen Patricia (2009) Mistrust of Health Care Organizations Is Associated with Underutilization of Health Services. Health Services Research, 44 (6). pp. 2093-2105. ISSN 00179124

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Abstract

PURPOSE: We report the validation of an instrument to measure mistrust of health care organizations and examine the relationship between mistrust and health care service underutilization. METHODS: We conducted a telephone survey of a random sample of households in Baltimore City, MD. We surveyed 401 persons and followed up with 327 persons (81.5 percent) 3 weeks after the baseline interview. We conducted tests of the validity and reliability of the Medical Mistrust Index (MMI) and then conducted multivariate modeling to examine the relationship between mistrust and five measures of underutilization of health services. RESULTS: Using principle components analysis, we reduced the 17-item MMI to 7 items with a single dimension. Test-retest reliability was moderately strong, ranging from Pearson correlation of 0.346-0.697. In multivariate modeling, the MMI was predictive of four of five measures of underutilization of health services: failure to take medical advice (b=1.56, p<.01), failure to keep a follow-up appointment (b=1.11, p=.01), postponing receiving needed care (b=0.939, p=.01), and failure to fill a prescription (b=1.48, p=.002). MMI was not significantly associated with failure to get needed medical care (b=0.815, p=.06). CONCLUSIONS: The MMI is a robust predictor of underutilization of health services. Greater attention should be devoted to building greater trust among patients.


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Item Type: Article
Additional Information: This article is available at the publisher’s Web site. Access to the full text is subject to the publisher’s access restrictions.
Uncontrolled Keywords: Trust; mistrust; help seeking; underutilization; measurement;scale; factor analysis; principle components analysis
Subjects: Health > Health Equity > Access To Healthcare
Practice
Research
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Depositing User: Users 141 not found.
Date Deposited: 26 Jun 2011 17:34
Last Modified: 26 Jun 2011 17:36
Link to this item (URI): http://health-equity.lib.umd.edu/id/eprint/2637

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