Russian Society's Trust and Distrust to the Institution of Healthcare: Social Indicators and Post-pandemic Effects

Abstract

The topicality of the article stems from the necessity for a sociological interpretation and measurement of public confidence in the institution of healthcare in terms of changes, caused by the COVID-19 pandemic during the last years. The disadvantage of most studies of trust/distrust, regardless of the scientific field, is the confidence in a generally accepted concept of trust. Therefore, most sociological diagnostics are usually reduced to identifying some kinds of indices and averages of trust, satisfaction, and expectations of medical care consumers. In this regard, the purpose of the research is to conduct a comprehensive assessment of social perceptions, practices, behavioral attitudes that form a system of indicators of public confidence in the institution of healthcare. The structure of trust/distrust of Russian society towards healthcare at the stage of normalization of the epidemiological situation is shown based on the materials of an interregional questionnaire survey conducted by the team of contributors, as well as on the basis of secondary sociological data. The results lead to a paradoxical conclusion that generalized confidence in medical organizations has largely declarative and flexible nature and it is often unfocused for the patients and pre-patients. In real life situations requiring adequate therapeutic choice, medical care consumers demonstrate a fairly high degree of personal responsibility, moderately risky strategies of medical activity, an average level of compliance and a desire to receive medical care outside the region of permanent residence. In addition, trust is differentiated by the criteria of social capital, since it depends on having the familiar health workers, personal, family doctors. At the same time, trust/distrust towards healthcare is just an ideological and theoretical construct, an intuitive dynamic matrix. Due to this matrix an individual complex of adaptive self–preservation reactions is reproduced for each person, leading to both positive and undesirable effects.

Funding: The study was carried out as part of the implementation of the grant of the President of the Russian Federation for state support of young Russian scientists – candidates of sciences (MK-1818.2022.2) "Dynamics of social trust of the Russian society in the healthcare institution in the context of the COVID-19 pandemic".