Health Outcomes and Patient Empowerment

Abstract

Scholars claim that the outcomes of health interventions are the products of three factors: the size, the penetration and the sustainability of their effects. Nonetheless, the prevailing biomedical ethic of care engenders a mere ‘fix-it’ approach, which focuses on the clinical treatment of the disease and neglects the role of patients in the process of care. This approach undermines both the size and the penetration of health interventions. From this standpoint, the authors examine different health interventions aimed at improving the size and the penetration of their effects through the empowerment of the patients and their involvement in the provision of care. They are confronted in terms of two different criteria: the ‘intensity’ of the health care co-production and the ‘breadth’ of the health-related needs contemplated. Besides, their outcomes—in terms of health status improvement, patients’ satisfaction and cost savings—have been contrasted. A detailed case study dealing with a pilot project launched in Italy, which involved full-fledged empowerment of the patient, is presented. It is compared with similar initiatives carried out in other European and non-European countries, with the purpose of stressing the peculiarities of the former and explaining the reasons for its success. The findings of this study support the exploratory hypothesis that the higher the intensity of co-production and the wider the breadth of health-related needs considered, the better the outcomes of health interventions.

Empowering Patients to Co-Create a Sustainable Healthcare Value

“…However, while previous works were limited to measuring these dimensions in patients with different conditions [26,40,60,80,94,126], this research adds value by showing some possible consequences of patient empowerment in terms of value cocreation behaviors. The consequences of empowerment had previously been investigated mainly in terms of improving health and well-being [86,87,127,128] and in terms of patient satisfaction [129-…”

“…However, while previous works were limited to measuring these dimensions in patients with different conditions [26,40,60,80,94,126], this research adds value by showing some possible consequences of patient empowerment in terms of value co-creation behaviors. The consequences of empowerment had previously been investigated mainly in terms of improving health and well-being [86,87,127,128] and in terms of patient satisfaction [129][130][131], which can be considered a measure of service quality in healthcare [132,133]. According to the results of this research, patient empowerment should positively influence co-creation behaviors because from the analysis it emerges that the dimensions of empowerment have direct and positive effects on the patient's predisposition to implement behaviors of participation in health management and citizenship behaviors with health organizations.…”

“…According to WHO, patient empowerment could help solve some of the most demanding problems in modern healthcare, improve the quality of healthcare services [22] and reduce their costs [85], thus contributing to the sustainability of healthcare systems [23]. The contributions of patient empowerment to better healthcare sustainability and value are described in Table 1 [18][19][20][21][22][23][24][25]86,87].…”

Individual Health Budgets in Mental Health: Results of Its Implementation in the Friuli Venezia Giulia Region, Italy

“…Issue regarded, for instance, going beyond a resource allocating system focused on services, the increased bureaucracy, and the difficulties in managing PB founding among users and services, including the risk of a long-term dependency [5]. Although literature on the use and outcome evaluation of PB in Italy is scarce [17][18][19], first PB programs started as early as the 1990s in connection with the deinstitutionalization of psychiatric hospitals and the construction of a new model of psychiatric rehabilitation [17,20,21]. Nonetheless, only few Italian regions have adopted the PB as an integration tool for social and health interventions [22].…”

Framing the Shades of Sustainability in Health Care: Pitfalls and Perspectives from Western EU Countries

“…In general terms, financial sustainability engenders the enhancement of the health care system's long-term capacity to collect an adequate amount of financial assets to face the three major challenges that, nowadays, strain the proper functioning of health care organizations across the world: (a) the increasing financial pressures generated by the widespread diffusion of health-related technologies and innovations [19]; (b) the need for timely institutional, structural, and management changes brought by the epidemiological transition toward the prevalence of long-term diseases [20]; and (c) the growing health needs expressed by the community, due to the gradual-but steady-process of population ageing [21,22]. It is worth noting that the effective use of available resources depends, at the organizational level, on the accomplishment of economic sustainability [23], which derives from the improvement of health care providers' ability to maximize the value they are capable to obtain from the provision of health services [24]. Obviously, value maximization is realized by avoiding the misuse of current health-related resources and promoting patients' appropriate access to care [25].…”