This article builds upon a multilevel theory of trust to explore the relationship between general trust in health care systems and general trust in physicians and the social-contextual factors that shape this relationship. We develop a model of trust in physicians emphasizing the embeddedness of individuals in broader social-institutional contexts. We analyze data from 30 countries in the 2011 International Social Survey Program (N = 38,068) and specify hierarchical linear models with macro-micro level interactions. At the individual level, we find that individuals who trust the health care system are more likely to trust physicians in general. At the country level, we find that respondents from countries with predominately publicly financed health care systems are more likely to trust physicians than their counterparts in countries with less public funding of the health care system. Finally, we find that the greatest predicted probability of trust in physicians is found among individuals who trust their publicly funded health care system and the lowest probability is among individuals who have no confidence in their privately funded health care system. Based on these findings, we call for greater attention to the interaction of micro- and macro-level factors in models of trust in physicians cross-nationally.

本文建立在多层次信任理论的基础上，探讨对医疗保健系统的普遍信任与对医生的普遍信任之间的关系，以及形成这种关系的社会背景因素。我们开发了一种对医生的信任模型，强调个人在更广泛的社会制度环境中的嵌入性。我们在 2011 年国际社会调查计划（N = 38,068) 并指定具有宏观-微观层面相互作用的分层线性模型。在个人层面，我们发现信任医疗保健系统的个人通常更可能信任医生。在国家层面，我们发现来自公共资助医疗保健系统的国家的受访者比公共医疗保健系统公共资金较少的国家的受访者更有可能信任医生。最后，我们发现信任医生的最大预测概率出现在信任其公共资助医疗保健系统的个人中，而最低概率出现在对其私人资助医疗保健系统不信任的个人中。基于这些发现，