Trust in the healthcare system as a predictor of patient satisfaction: a cross-sectional survey in Türkiye’s primary care setting


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Topuz İ., Nal M., Durmuş V., Bektaş G.

BMC PUBLIC HEALTH, vol.25, pp.1-9, 2025 (SCI-Expanded, Scopus)

  • Publication Type: Article / Article
  • Volume: 25
  • Publication Date: 2025
  • Doi Number: 10.1186/s12889-025-25117-6
  • Journal Name: BMC PUBLIC HEALTH
  • Journal Indexes: Food Science & Technology Abstracts, Scopus, Agricultural & Environmental Science Database, Science Citation Index Expanded (SCI-EXPANDED), Academic Search Premier, CINAHL, EMBASE, CAB Abstracts, MEDLINE, Pollution Abstracts, Public Affairs Index, Veterinary Science Database, Directory of Open Access Journals
  • Page Numbers: pp.1-9
  • Open Archive Collection: AVESIS Open Access Collection
  • Kütahya Health Sciences University Affiliated: Yes

Abstract

Background Patient satisfaction is a fundamental indicator of healthcare quality. However, while structural factors affecting satisfaction have been extensively studied in the literature, perceptions of the service process and the communication dimension have been relatively neglected. It offers concrete suggestions for developing strategies to increase trust in the health system, improve patient satisfaction, and achieve sustainable quality in health services. This study aims to examine the relationship between trust in the healthcare system and the level of patient satisfaction. Methods This study used a descriptive cross-sectional design. Data were collected in Türkiye between March and August 2023 through an online survey using the snowball sampling method, involving 1010 individuals utilizing family medicine services. Validated instruments included: (1) a Descriptive Characteristics Form covering gender, education, and employment; (2) the Trust in the Health Care System Scale; and (3) a Patient Satisfaction Scale. Results Trust correlated strongly with satisfaction (r = 0.715, p < 0.001). Regression analysis showed trust subdimensions significantly predicted satisfaction (R²=0.512), with marital and employment status also influencing outcomes (p < 0.05). Trust in the healthcare system strongly predicted patient satisfaction (p < 0.001) and explained significant variance (Nagelkerke R²=0.512). Conclusion This study found that patient satisfaction is significantly influenced by individual characteristics, service quality, and trust in the healthcare system. These findings suggest that policies to enhance patient satisfaction should adopt comprehensive strategies that reinforce public trust in all aspects of the healthcare system. Policies should not only focus on service delivery to enhance patient satisfaction, but also adopt comprehensive strategies that strengthen trust in the healthcare system. Policies aimed at increasing trust should incorporate multidimensional strategies, including transparency, accountability, effective communication, and the sustainability of service quality. These approaches will not only improve current satisfaction levels but also strengthen long-term social commitment to the healthcare system.