CERGAS Seminar "Trust in Health Care Systems and Care-Seeking Behavior: Evidence from Italy and the United States."

Trust in health care systems is widely viewed as central to whether people seek care, comply with recommendations, and engage with preventive services. This talk presents new evidence from original survey data collected in the United States and Italy to measure trust in the health care system and in specific institutions (e.g., clinicians, hospitals, insurers, pharmaceutical companies, and regulators), and to examine how trust relates to health care–seeking behaviors. I first describe levels and correlates of trust across the two countries, with a focus on perceived competence, capacity, and benevolence as drivers of trust. I then link trust to both retrospective utilization and prospective intentions to seek care, highlighting patterns that are common across contexts as well as country-specific differences. Building on recent work, I emphasize that “trust in health care” is inherently multi-entity: individuals may trust some parts of the system and distrust others, and these components can matter as complements or substitutes. I discuss a simple framework in which trust shapes care-seeking through three channels—beliefs about effectiveness, the (dis)utility of interacting with the system, and expectations about realized prices (out-of-pocket exposure and claim denials)—and show how these mechanisms help interpret patterns of preventive care, elective care, and care avoidance. I conclude by discussing implications for research, policy, and communication strategies aimed at strengthening trust and improving appropriate use of health services.

Speaker:

Mario Macis is a Full Professor of Economics at Johns Hopkins University’s Carey Business School, where he also serves as Economics Area Chair. He is a member of the Core Faculty and Leadership Team of the Hopkins Business of Health Initiative (HBHI), an affiliate faculty member at the Johns Hopkins Berman Institute of Bioethics, and a Research Associate at the National Bureau of Economic Research (NBER). He also edits the “Salute e Economia” section of the Italian monthly economics magazine Eco. His research spans health economics, market design, development economics, and labor economics. He has published in leading academic journals, including the American Economic Review, American Economic Journal: Applied Economics, American Economic Journal: Economic Policy, the Journal of Labor Economics, the Journal of Health Economics, the American Journal of Health Economics, the Journal of Development Economics, Management Science, Sociological Science, and Science. He has served as a consultant for several international organizations, including the World Bank, the International Labour Organization, the National Marrow Donor Program, the United Nations Development Programme, and the World Health Organization. In 2021–2022, he served on a National Academies of Sciences, Engineering, and Medicine (NASEM) committee on “A Fairer and More Equitable, Cost-Effective, and Transparent System of Donor Organ Procurement, Allocation, and Distribution.”

Link zoom:

https://unibocconi-it.zoom.us/j/99968618670?pwd=ARVM37HfqN0Wfx2CIDgXvoTpoCNsac.1

Meeting ID:

999 6861 8670

Passcode:

189013

Lunch at the end of the meeting: for those willing to participate in person, click here before the 14th of April.