Trust in Health Care Systems and Care-Seeking Behavior: Evidence from Italy and the United States with Professor Mario Macis

The seminar “Trust in Health Care Systems and Care-Seeking Behavior: Evidence from Italy and the United States” will be held on April 21, from 3:00 to 4:00 PM, in the Aula Magna, and will feature Mario Macis, Full Professor of Economics at Johns Hopkins University.

Drawing on original survey data from the United States and Italy, the talk explores how trust in health care systems—and in key actors such as clinicians, hospitals, and regulators—shapes individuals’ decisions to seek care, follow medical advice, and engage in preventive services. It highlights the multi-dimensional nature of trust and its role in influencing health behaviors through perceptions of effectiveness, costs, and interactions with the system.

The seminar will offer valuable insights for understanding health care utilization patterns and will discuss implications for policy, research, and communication strategies aimed at strengthening trust and improving access to care.

Abstract:

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, examining trust in the healthcare system and in specific actors (clinicians, hospitals, insurers, pharmaceutical companies, and regulators), and its relationship with health care–seeking behavior. It outlines levels and correlates of trust across the two countries—focusing on perceived competence, capacity, and benevolence—and links trust to both retrospective utilization and prospective intentions to seek care, highlighting patterns that are common across contexts as well as country-specific differences. The analysis emphasizes 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. Then the talk addresses a simple framework showing how trust affects behavior through three channels: beliefs about effectiveness, (dis)utility of interacting with the system, 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. The talk concludes with implications for research, policy, and communication strategies aimed at strengthening trust and promoting appropriate use of health services.

Bio:

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 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.