Co-created Decision Making: From Co-production to Value Co-creation in Health Care

Abstract

Rare diseases are characterized by a wide diversity of signs and symptoms and vary not only from disease to disease, but also from person to person, and living with a disease leads patients to peculiar experiences and treatments, without limits of time and space, as they extend to various environments and relationships of their lives. The objective of this study is the theoretical interaction between Value Co-creation (VC) and the Stakeholder Theory (ST) with the Shared Decision Making (SDM) health care theory. It is configured as a multiparadigmatic proposal by enabling the analysis of multiple perspectives of different stakeholders in health care. Thus, Co-created Decision Making (CDM) emerges in a logic dominated by service, with emphasis on intangible aspects and the interactivity of the relationships. It goes beyond the clinical office and the doctor-patient relationships, as studied in SDM, extending to all environments and interactions that add value to the patient's treatment. It was concluded that the essence of this new theory proposed here is neither in patient-centered care nor in patient self-care, but in co-created relationships with and between stakeholders in both directions, including non-health care environments that are important to the patient, such as relationships with friends, family, other patients with the same disease, social media, public policies, and the practice of pleasurable activities.

Perceptions of foot health services from the perspective of patients with rheumatoid arthritis in Finland

“…Patients would also be more satisfied with access to care as their waiting times would be shorter and they would see that their foot health is being taken into account. Co‐creation [26] together with people with RA could help find solutions to overcome the shortcomings of foot health care in the current health care systems. In future studies, the use of structured self‐rated foot health questionnaire together with instrument measuring perceived lower extremity function could provide a comprehensive overview of lower extremity health and thus produce evidence for the need of foot health services.…”