Trust in the health care professional and health outcome: A meta-analysis

PLoS One. 2017 Feb 7;12(2):e0170988. doi: 10.1371/journal.pone.0170988. eCollection 2017.


Objective: To examine whether patients' trust in the health care professional is associated with health outcomes.

Study selection: We searched 4 major electronic databases for studies that reported quantitative data on the association between trust in the health care professional and health outcome. We screened the full-texts of 400 publications and included 47 studies in our meta-analysis.

Data extraction and data synthesis: We conducted random effects meta-analyses and meta-regressions and calculated correlation coefficients with corresponding 95% confidence intervals. Two interdependent researchers assessed the quality of the included studies using the Strengthening the Reporting of Observational Studies in Epidemiology guidelines.

Results: Overall, we found a small to moderate correlation between trust and health outcomes (r = 0.24, 95% CI: 0.19-0.29). Subgroup analyses revealed a moderate correlation between trust and self-rated subjective health outcomes (r = 0.30, 0.24-0.35). Correlations between trust and objective (r = -0.02, -0.08-0.03) as well as observer-rated outcomes (r = 0.10, -0.16-0.36) were non-significant. Exploratory analyses showed a large correlation between trust and patient satisfaction and somewhat smaller correlations with health behaviours, quality of life and symptom severity. Heterogeneity was small to moderate across the analyses.

Conclusions: From a clinical perspective, patients reported more beneficial health behaviours, less symptoms and higher quality of life and to be more satisfied with treatment when they had higher trust in their health care professional. There was evidence for upward bias in the summarized results. Prospective studies are required to deepen our understanding of the complex interplay between trust and health outcomes.

Publication types

  • Meta-Analysis

MeSH terms

  • Databases, Factual
  • Health Personnel*
  • Humans
  • Outcome Assessment, Health Care*
  • Patient Satisfaction
  • Publication Bias
  • Trust*

Grants and funding

Johanna Birkhäuer's contributions to this study were supported by the Swiss National Science Foundation (, grant project (P0BSP1_155446). The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.