Everyday Encounters with Public Authority: Healthcare Experiences and Differentiated Institutional Trust Across Europe

Citizens encounter public authority not only through elections and policy debates but also through routine interactions with public services. This article examines how recent healthcare encounters are associated with trust in government, parliament and local authorities, and whether these relationships are organised through broader evaluations of service performance. Using the 2016 European Quality of Life Survey, the analysis compares recent users of general-practitioner and hospital or specialist services across the EU28. Country fixed-effects models distinguish the total association of encounter quality with institutional trust from the component linked to general service evaluation and the residual association with the concrete encounter. Better healthcare experiences are associated with greater trust in all three institutions. For government and parliament, most of this relationship is connected to broader judgements of service performance and the residual encounter coefficients are small. For local authorities, the residual coefficients are substantially larger, although stringent controls for broader place-based and institutional evaluations reduce their magnitude, particularly for hospital care. Cross-national meta-regressions further show that the local pattern is not systematically stronger where healthcare spending is more decentralised. The findings therefore point to institutionally differentiated pathways through which ordinary service encounters become politically meaningful.