Mistrust of health care organizations is associated with underutilization of health services.
Mistrust of health care organizations is associated with underutilization of health services.
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DOI：
10.1111/j.1475-6773.2009.01017.x
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发表时间：
2009-12
影响因子：
3.4
通讯作者：
Williams KP
中科院分区：
文献类型：
--
作者：
LaVeist TA;Isaac LA;Williams KP
我们报告了一种测量医疗机构不信任的工具的验证，并检查不信任与医疗服务利用不足之间的关系。我们对马里兰州巴尔的摩市的随机家庭样本进行了电话调查。我们调查了401人，并在基线访谈后3周对327人（81.5%）进行了随访。我们对医疗不信任指数（MMI）的效度和信度进行了测试，然后进行了多变量建模，以检验不信任与卫生服务利用不足的五项措施之间的关系。通过主成分分析，我们将17个项目的MMI缩减为7个项目。重测信度中等强，Pearson相关为0.346-0.697。在多变量模型中，MMI可以预测卫生服务利用不足的五项指标中的四项：未接受医疗建议（b = 1.56, p< 0.01），未遵守随访预约（b = 1.11, p = 0.01），推迟接受所需护理（b = 0.939, p = 0.01），以及未按处方配药（b = 1.48, p = 0.002）。MMI与未能获得所需医疗护理无显著相关（b = 0.815, p = 0.06）。MMI是卫生服务利用不足的可靠预测指标。应该更加重视在病人之间建立更大的信任。
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. 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. 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). 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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影响因子：
5.7
作者：
Rose, A;Peters, N;Armstrong, K
通讯作者：
Armstrong, K
影响因子：
120.7
作者：
Mechanic, D;Schlesinger, M
通讯作者：
Schlesinger, M
影响因子：
3.4
作者：
Couch, LL;Adams, JM;Jones, WH
通讯作者：
Jones, WH
影响因子：
3
作者：
Thom, DH;Ribisl, KM;Luke, DA
通讯作者：
Luke, DA
DOI：
10.1016/s0735-1097(03)00042-1
发表时间：
2003-04-02
影响因子：
24
作者：
LaVeist, TA;Arthur, M;Plantholt, S
通讯作者：
Plantholt, S