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Public evaluation of health services across 21 European countries: The role of culture
Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Sociology. (VÄLFÄRD OCH LIVSLOPP (Welfare and Lifecourse))ORCID iD: 0000-0003-0679-4940
Department of Sociology and Political Science, Norwegian University of Science and Technology, Norway.
Department of Sociology and Political Science, Norwegian University of Science and Technology, Norway.
Department of Sociology and Political Science, Norwegian University of Science and Technology, Norway.
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2017 (English)In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 45, no 2, p. 132-139Article in journal (Refereed) Published
Abstract [en]

Aims: This work examined the role of cultural values in understanding people’s satisfaction with health services across Europe. Methods: We used multilevel linear regression analysis on the seventh round of the European Social Survey from 2014, including c. 40,000 respondents from 21 countries. Preliminary intraclass correlation analyses led us to believe that some explanations of variance in the dependent variable were to be found at the country level. In search of country level explanations, we attempted to account for the role of national culture in influencing citizens’ attitudes towards health systems. This was done by using Hofstede’s dimensions of power distance, individualism, masculinity and uncertainty avoidance, giving each country in the survey a mean aggregated score. Results: In our first model with individual level variables, being female, having low or medium education, experiencing financial strain, and reporting poor health and unmet medical needs were negatively associated with individual satisfaction with national healthcare systems, with the latter variable showing the strongest effect. After including Hofstede’s cultural dimensions in our multilevel model, we found that the power distance index variable had a negative effect on the dependent variable, significant at the 0.1 level. Conclusions: Citizens are likely to evaluate their national health system more negatively in national cultures associated with autocracy and hierarchy.

Place, publisher, year, edition, pages
2017. Vol. 45, no 2, p. 132-139
Keywords [en]
Public evaluation of healthcare, satisfaction with healthcare, Hofstede’s cultural dimensions, multilevel analysis, Europe, European Social Survey (ESS)
National Category
Public Health, Global Health, Social Medicine and Epidemiology Sociology (excluding Social Work, Social Psychology and Social Anthropology)
Research subject
International Health; Health Care Research
Identifiers
URN: urn:nbn:se:uu:diva-315249DOI: 10.1177/1403494816685920ISI: 000394790900006PubMedID: 28129723OAI: oai:DiVA.org:uu-315249DiVA, id: diva2:1073585
Available from: 2017-02-11 Created: 2017-02-11 Last updated: 2017-04-27Bibliographically approved

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