title: Public trust in health care: a performance indicator?
abstract: OBJECTIVE
  If public trust in health care is to be used as a performance indicator for health care systems, its measurement has to be sensitive to changes in the health care system. For this purpose, this study has monitored public trust in health care in The Netherlands over an eight-year period, from 1997 to 2004. The study expected to find a decrease in public trust, with a low point in 2002.
  
  
  METHODS
  Since 1997, public trust in health care was measured through postal questionnaires to the "health care consumer panel". This panel consists of approximately 1500 households and forms a representative sample of the Dutch population.
  
  
  RESULTS
  Trust in health care and trust in hospitals did not show any significant trend. Trust in medical specialists displayed an upward trend. Trust in future health care, trust in five out of six dimensions of health care and trust in general practitioners actually did show a decrease. However, only for trust in macro level policies and trust in professional expertise this trend continued. For the remaining trust objects, after 1999 or 2000, an upward trend set in.
  
  
  CONCLUSIONS
  No support was found for our overall assumption. Explanations for the fact that trust did increase after 1999 or 2000 are difficult to find. On the basis of these findings the study questions whether the measure of public trust is sensitive enough to provide information on the performance of the health care system.
  
  
  CONCLUSIONS
  The aim of this research is to study public trust in health care on its abilities to be used as a performance indicator for health care systems.
authors.affiliation: Netherlands Institute for Health Services Research, Utrecht, The Netherlands.
authors.forename: Evelien
authors.initials: E
authors.lastname: Van der Schee
authors.forename: Peter P
authors.initials: PP
authors.lastname: Groenewegen
authors.forename: Roland D
authors.initials: RD
authors.lastname: Friele
mesh_terms: D003695:Delivery of Health Care; D006801:Humans; D009313:National Health Programs / Q000458:organization & administration; D009426:Netherlands; D011639:Public Opinion; D011795:Surveys and Questionnaires; D035502:Trust