What if things go wrong in co-producing health services? Exploring the implementation problems of health care co-production

Abstract

Patient-centered care and health services' co-production are the cornerstones of the health care system of the future. These constructs rely on the reconceptualization of the patient as a co-deliverer of care. While studies about the intrinsic value-added of health services' coproduction are prominent, the risks of value co-destruction attached to patient involvement have been widely neglected. In an attempt to fill this gap, this paper draws on the 'health literacy' perspective to conceptually explore the 'dark side' of health services' co-production. Value co-destruction is understood as a two-way street, where both the health care professionals and the patients are likely to walk, either intentionally or unintentionally. Individual and organizational health literacy are proposed as two essential ingredients of the recipe for effective health services' co-production, reducing the risks of value co-destruction in health services' provision.

The Potential Pitfalls of Co-production: An Overview on the Co-design of Public Services with and for Family Caregivers Living in Rural and Remote Area

“…The rst group comprises antecedents that limit the effectiveness of the 'interactional process' due to the lack of resources by consumers and/or providers. This group includes consumers the lack of technical information [16], knowledge of users' needs and expectations [19], transparency and understanding of each other parties' roles and responsibilities [15], trust [37] and public investment [25]. The second group of antecedents of co-destruction consists of limitations related to the context of analysis such as rigidities of the public service organizations [19].…”

“…However, the involvement of vulnerable and marginalized users may increase the risk of diverting a coproduction process towards a co-destruction process [16]. The current literature identi es four main challenges that facilitate the failure of co-production with vulnerable and marginalized actors.…”

“…The factors that cause co-destruction are not easy to detach [15]. For instance, an interactional process between users and providers may fail because users do not have enough information about the topic of discussion [16]. On the contrary, it may fail because the organization does not want to share some information with users [15] or because the local rules and regulations do not allow organizations to share that information [17].…”

Evaluation of a national training programme to support engagement in mental health services: Learning enablers and learning gains

“…A series of challenges exist with regard to realizing the ambition of bona fide SU-CG involvement in practice; some of which includes definitional issues (Filipe, Renedo, & Marston, 2017;Millar, Chambers, & Giles, 2015;Bee, Brooks, Fraser, & Lovell, 2015), tokenism (Chambers et al, 2017;Lemonsky, 2015), power imbalance and professional attitudes (Clark, 2015) and financial (Slay & Stephens, 2013). Given these challenges, it is perhaps unsurprising that, what Palumbo and Manna (2017) describe as, co-destruction can occur. To counter this, they suggest increasing organizational and health literacy as means of empowering participants in involvement processes and practices.…”

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

“…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].…”