AUTHOR=Vora Kranti , Saiyed Shahin , Mavalankar Dileep , Baines Lyndsay S. , Jindal Rahul M. 

TITLE=Trust Deficit in Surgical Systems in an Urban Slum in India Under Universal Health Coverage: A Mixed Method Study

JOURNAL=International Journal of Public Health

VOLUME=Volume 67 - 2022

YEAR=2022

URL=https://www.ssph-journal.org/journals/international-journal-of-public-health/articles/10.3389/ijph.2022.1604924

DOI=10.3389/ijph.2022.1604924

ISSN=1661-8564

ABSTRACT=Objectives: We carried out a mixed method study to understand why patients did not avail of  surgical care in an urban slum in India.

Methods: In our earlier study, we found that out of 10,330 people - 3.46% needed surgery; 42% did not avail of surgery (unmet need). We conducted a follow-up study to understand reasons for not availing surgery, 141 in met needs, 91 in unmet needs. We administered 2 instruments, 16 in-depth interviews and 1 focused group discussion.

Results: Responses from the 2 groups for ‘the Socio-culturally Competent Trust in Physician Scale for a Developing Country Setting’ scale did not have a significant difference except for, prescription of medicines, patients with unmet needs were less likely to agree (p=0.076). Results between 2 groups regarding ‘Patient perceptions of quality’ did not show significant difference except for doctors answering questions where a higher proportion of unmet need group agreed (p=0.064). Similar observations were made in the qualitative study. 

Conclusions:  There is a need for societal action to remove gender discrimination and government assistance to cover lost wages during hospitalization.