title: Healthcare plans and consumer perceptions of healthcare institutions.
abstract: OBJECTIVE
  This study evaluates the effect of healthcare insurance plans on consumer perception of trust in a healthcare institution, and the mediating effect of trust on consumer loyalty towards an institution.
  
  
  METHODS
  The study was conducted at a healthcare institution in Colombia where a total of 841 patients responded to a questionnaire.
  
  
  RESULTS
  A structural equation model shows that individuals who have a pre-paid healthcare plan have a stronger evaluation of trust compared to those who hold a regulated healthcare plan (i.e., subsidized and contributory plans). In turn, trust positively predicts consumers' loyalty towards an institution. The relationship between the patients' healthcare plans and their degree of loyalty towards healthcare institutions is completely mediated by their perception of trust towards the institution.
  
  
  CONCLUSIONS
  A greater perception of trust is explained by having a medical plan that provides consumers with more flexibility, allowing them to select their health provider at a premium price. Although health institutions do not control healthcare regimes, these affect consumers' trust in their service. Institutions cannot modify characteristics of the regime, but they can promote a trustworthy environment to strengthen consumers' loyalty to the institution.
authors.affiliation: Department of Marketing and International Business, ICESI University, Cali, Colombia, amarboleda@icesi.edu.co.
authors.forename: Ana M
authors.initials: AM
authors.lastname: Arboleda-Arango
mesh_terms: D000328:Adult; D000368:Aged; D001294:Attitude to Health; D003105:Colombia; D003258:Consumer Behavior; D005260:Female; D019538:Health Care Surveys; D006268:Health Facilities; D006801:Humans; D019458:Insurance Coverage; D007348:Insurance, Health; D008297:Male; D008875:Middle Aged; D009313:National Health Programs; D011795:Surveys and Questionnaires; D035502:Trust