Corruption, public trust and medical autonomy in the public health sector of Montenegro: Taking stock of the COVID-19 influence

Abstract

In this paper, we analyze the influence of corruption perception, experiences of corruptive behavior, and healthcare autonomy on the public trust in Montenegrin healthcare, by surveying the general population before and after the global COVID-19 pandemic. By providing a quasi-replication of a previous empirical study of corruption and trust in the Croatian public healthcare sector, we introduce the COVID-19 pandemic as a new research context. Before the pandemic, we found a consistent and significant negative influence of the corruptive practices and the generally perceived level of corruption (corruption salience) on the trust in public healthcare. The emergence of COVID-19 had mixed effects: while there is a slightly higher effect of corruption salience to the preference of public healthcare, corruptive experiences still matter but are tolerated much higher than before the pandemic. Public assessment of the autonomy of the health system increases preference for public healthcare, both before and after the pandemic, although the emergence of COVID-19 somewhat lowers this effect. The obtained results point to the most significant challenges of the ‘post-COVID-19’ social context to public health policymaking and management of public healthcare institutions. These include focusing the public healthcare reforms on corruption, reducing waiting times for different diagnostics and medical procedures in the public healthcare system, and regulating the ‘dual practice’ (simultaneous work in public and private healthcare institutions).

Differences of corruption types in selected Western and central-eastern health systems during the COVID-19 pandemic: a rapid review

“…Decentralized authorities were involved in one case in WE ( 9 ). An authority from a supranational organization was involved in one case in Poland ( 27 ), while a supplier was responsible for a case of health corruption in the Netherlands ( 37 ).…”

“…Evaluations of corruption during the pandemic are still emerging among European countries, with the number of reports expected to increase as data on procurement and resource allocation is analyzed by researchers, media, and watchdogs. Recent literature in the field has explored the impacts of corruption on public trust and mortality due to COVID-19 ( 37 , 38 ).…”

The public, the pandemic, and the public service: The case of Alberta

“…Similar trends have been observed at local, subnational, and national levels where individuals had more trust if they believed the agency had proper scientific expertise (SteelFisher et al, 2023). Institutional autonomy, freedom from interference from the private sector, and low corruption perceptions were also correlated with increased trust (Radević et al, 2022; SteelFisher et al, 2023). In Europe, research suggests that polarisation was a more likely cause of varying levels of trust in public servants than public health policies (Nielsen & Lindvall, 2021).…”

The Roles of Professional Socialization and Higher Education Context in Prosocial and Pro-Environmental Attitudes of Social Science and Humanities versus Business Students in Italy and Croatia

“…Students in helping professions, i.e., the social sciences and humanities, have a much higher prosocial orientation than those enrolled in business studies, which could be expected considering the previously discussed theoretical background. Italian students consistently outperform Croatian students, which could be attributed to the lower level of social capital [55] and trust [56] in the region of southeast Europe (SEE) when compared to the other European regions.…”