Re-building the trust relationship between people and the public health system. An Italian exploratory study.

The identity of public institutions is nowadays undermined by negative media campaign and societal changes leading to a greater individual autonomy in searching for information without looking at their sources’ reliability. Identity and trust are linked concepts and the relationship management practices put in place by the public institutions influence the both of them. The health systems need to work in managing the relation with people in order to have an impact on their trust level and re-value the health system’s identity. This work aims at exploring which could be the elements to work on in addressing this challenge, considering both the context and the users behaviors and expectations. To this end, a multilevel ordinal logistic regression model was performed on data based on an Italian sample of 1478 respondents. Results confirm that the experience with high specialized services (like outpatient and diagnostic services) are fundamental to build institutional trust, while living a bad experience with healthcare services loose a large amount of trust in the system shaming on it for the bad experience. To re-build the trust relationship between individuals and the health system should continuously work on the performance and on the quality of the users’ experience.