Long Term Care Decisions Rely on Trust

Policy Analysis

Long Term Care Decisions Rely on Trust

The pandemic has done much to reveal the importance of citizens’ trust in government, for both public policy implementation and improved social outcomes. Decades of “bureaucracy bashing” has left many Americans with negative views of the public sector, blaming it for a wide array of social problems.

To help assess this anti-public sector bias, SPA Professors Anna Amirkhanyan and Ken Meier, with coauthors Jourdan Davis (assistant professor, University of North Carolina-Charlotte) and Miyeon Song (assistant professor, Rutgers University), conducted an original research experiment to explore how citizens think of governments, for-profit, and nonprofit organizations and consider performance information. Their findings, written up in “,” will appear in an upcoming issue of Public Administration Review, the field’s premier journal.

Their results suggest that, in fact, American citizens are not biased against government. In the field of long-term care, individuals have no anti-public sector bias, and hold more favorable views of nonprofit organizations than for-profits.

“It’s a cliché, but we truly live in the information age” said Amirkhanyan. “People constantly receive information from many different sources, including government agencies. While some has to do with fairly mundane choices and activities, other information can help save lives and affect our future. Understanding if Americans are listening to their government in an unbiased way, without discounting its content, is therefore important.”

The study also found that the source of performance information matters. Individuals consider government and nonprofit sources of information to be more credible than for-profit sources, and simple, unambiguous performance data can further diminish perceived bias.

“In highly partisan environments, a great deal of information is designed to persuade rather than inform,” said Meier. “Direct factual communication is avoided [in favor of] information that is slanted or even blatantly false. Our study shows that government evaluation systems can break through this blizzard of disinformation and provide useful data to the public.”

Government must continue collecting and disseminating performance data on itself, the authors argue, as well as on private entities regulated and financed by the public.

“Our research shows that public organizations can do a great deal to communicate effectively about the performance of public programs,” said Meier. “When there are clear metrics such as the Five-Star system used for nursing homes that come from credible sources such as independent government auditors, citizens form accurate perceptions of service quality.”

The consequences of anti-public-sector bias can be significant for both government and society itself.

“Negative views of government can discourage people from paying taxes, supporting government policies, and complying with laws and regulations,” said Amirkhanyan. “They can also lower public employees’ morale and hurt recruitment and retention of talent in government agencies.”

The authors focused on nursing homes because their evaluation systems are similar to those used in hospitals, schools, and other social service organizations, and utilized a distinct research design.

“Our experimental approach is designed to provide a clear causal assessment of both performance information and source credibility in a real-world situation (the selection of a nursing home),” said Meier. “This permits us to determine if any biases creep in . . . That our findings show no bias is good news in terms of how government evaluation of programs can help citizens make informed choices.”

This particular collaboration showcases SPA’s apprenticeship model of joint research. Each doctoral student is paired with a faculty mentor, who helps them produce methodologically sound, theoretically innovative research. By graduation, virtually all PhD students have presented at conferences and published in peer-reviewed academic journals. Both Davis and Song have benefited from this model.
"Working with Ken and Anna has changed the trajectory of my research career,” said Davis, who earned her PhD in Public Administration and Policy in Spring 2021. “Both are prolific, but also generous in their willingness to include students on their most interesting projects. Without Ken's guidance on my dissertation, it would have gone in a completely different direction; I couldn't be happier with the result."

It helps that SPA strategically recruits and hires faculty with impactful research portfolios, added Amirkhanyan. “This vibrant and productive research environment helps attract outstanding PhD students,” she said. “The philosophy of our PhD program is to deliver more than just coursework. Our goal is to train the next generation of leading scholars, who advance theory, methods, and policies and inform solutions to today’s most pressing problems.”

These relationships, beyond contributing to the careers of both faculty and student, add value to their respective disciplines and larger academic traditions.

“The best way to learn to be a scholar is to participate in research with an experienced colleague,” said Meier. “The mentoring relationships in DPAP not only develop high quality scholars, but also instill in our graduates the importance of linking research and education in their future careers. The result is a cascade effect where the mentoring skills are reproduced and passed on to the next generation of scholars both at С��Ƶ and where the С��Ƶ PhDs go on to teach.”

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