Impact of public evaluation of the health security system on the trust in physicians: Mediating roles of satisfaction with medical care and perceptions of medical safety

Abstract

This empirical study investigates how evaluations of the health security system (independent variable) affect trust in physicians (dependent variable), focusing on the mediating role of medical satisfaction and perceptions of medical safety (mediators). Using 2017 and 2019 China Social Survey (CSS) data (N = 17,054, aged 18–70, Mean = 47.33, 55.13% female), findings reveal a significant positive relationship between evaluations of the health security system and trust in physicians. The relationship is partially mediated by satisfaction with medical care and perception of medical safety, and the satisfaction with medical care shows a stronger mediating effect. This research highlights the crucial role of institutional trust in shaping public trust in physicians, an often-overlooked factor in healthcare trust studies. By identifying satisfaction with medical care and perceptions of medical safety as key mediators, the study provides actionable insights for policymakers aiming to strengthen doctor-patient relationships through systemic healthcare improvements.