How Person-Centered Care shapes patients’ trust in healthcare: Insights from Portugal's PaRIS study

Abstract Patients’ experiences with healthcare can significantly shape their perception and, potentially, their trust in the health system, which is essential for the development of resilient and sustainable healthcare structures. The OECD, through the Patient-Reported Indicator Surveys (PaRIS) study, has played a key role in assessing patient-reported outcomes and experiences by implementing the first international survey focused on individuals living with chronic conditions, aimed at evaluating healthcare quality from their perspective. Two key dimensions measured in the PaRIS study, patients’ experiences with Person-Centered Care (measured by the P3CEQ Questionnaire) and trust in the healthcare system, can offer valuable insights into how healthcare experiences shape patient's trust and engagement. Using Portugal's PaRIS data, this research explored for the first time the association between Person-Centered Care and Trust in the healthcare system, as well as the influence of various sociodemographic and health factors on this relationship. A descriptive analysis was conducted, followed by the application of two multinomial multiple logistic regression models: one using the frequentist approach and the other based on Bayesian analysis, which accounted for differences between patients and healthcare providers. Both models revealed a positive correlation between patients’ experiences with Person-Centered Care and higher levels of trust in the health system, with various sociodemographic and health predictors, including education level, occupation level and both general and mental health, playing a key role in shaping this relationship. This association highlights the importance of personalized, coordinated, and patient-centered care in strengthening trust in healthcare systems. Moreover, it offers valuable insights to guide healthcare policies toward a more tailored approach that meets the expectations and needs of primary healthcare patients in Portugal. Key messages • Patients’ experiences with Person-Centered Care are strongly linked to trust in the healthcare system, with sociodemographic and health factors playing a crucial role in shaping this relationship. • Portugal’s healthcare policies should leverage PaRIS study insights to enhance Person-Centered Care, strengthening trust in primary care and ensuring services align with patient expectations and needs.