Co-production in chronic care: exploitation and empowerment

Essén, Anna; Värlander, Sara; Liljedal, Karina T.

doi:10.1108/ejm-02-2015-0067

Cited by 28 publications

(21 citation statements)

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“…[ [58]:551]. Others argue that it is engagement and co-production that boost empowerment because they increase confidence and give users a sense of influence or control [100]. The theme "quality improvement" focuses on the improvement of health services, which is achieved primarily through coproduction and personalisation of patient care [101,102].…”

Section: The Thematic Map: Co-word Analysismentioning

confidence: 99%

Co-production in health policy and management: a comprehensive bibliometric review

Fusco

Marsilio

Guglielmetti

2020

BMC Health Serv Res

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Background: Due to an increasingly elderly population, a higher incidence of chronic diseases and higher expectations regarding public service provision, healthcare services are under increasing strain to cut costs while maintaining quality. The importance of promoting systems of co-produced health between stakeholders has gained considerable traction both in the literature and in public sector policy debates. This study provides a comprehensive map of the extant literature and identifies the main themes and future research needs. Methods: A quantitative bibliometric analysis was carried out consisting of a performance analysis, science mapping, and a scientific collaboration analysis. Web of Science (WoS) was chosen to extract the dataset; the search was refined by language, i.e. English, and type of publication, i.e. journal academic articles and reviews. No time limitation was selected. Results: The dataset is made up of 295 papers ranging from 1994 to May 2019. The analysis highlighted an annual percentage growth rate in the topic of co-production of about 25%. The articles retrieved are split between 1225 authors and 148 sources. This fragmentation was confirmed by the collaboration analysis, which revealed very few long-lasting collaborations. The scientific production is geographically polarised within the EU and Anglo-Saxon countries, with the United Kingdom playing a central role. The intellectual structure consists of three main areas: public administration and management, service management and knowledge translation literature. The co-word analysis confirms the relatively low scientific maturity of co-production applied to health services. It shows few well-developed and central terms, which refer to traditional areas of co-production (e.g. public health, social care), and some emerging themes related to social and health phenomena (e.g. the elderly and chronic diseases), the use of technologies, and the recent patient-centred approach to care (patient involvement/engagement). Conclusions: The field is still far from being mature. Empirical practices, especially regarding co-delivery and comanagement as well as the evaluation of their real impacts on providers and on patients are lacking and should be more widely investigated.

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Section: The Thematic Map: Co-word Analysismentioning

confidence: 99%

Co-production in health policy and management: a comprehensive bibliometric review

Fusco

Marsilio

Guglielmetti

2020

BMC Health Serv Res

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“…The co-production is a way of empowering as well as exploiting actors [ 31 ]. The experience of value is highly contextual and directly influenced by the expectations toward a service [ 25 ].…”

Section: Introductionmentioning

confidence: 99%

Older People Negotiating Independence and Safety in Everyday Life Using Technology: Qualitative Study

Stokke

2018

J Med Internet Res

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BackgroundDue to demographic changes with an aging population, there is a demand for technology innovations in care services. However, technology innovations have proven difficult to implement in regular use. To understand the complexity of technology innovations in care practices, we need a knowledge base of the complex and diverse experiences of people interacting with established technologies.ObjectiveThis paper addresses the research gap in relation to understanding the microcontext of co-production of care involving established technologies integrated into care practices. The paper also aims to provide a framework for exploring what really happens when different actors use technology in care practices.MethodsParticipant observations and 22 interviews with actors using social alarms were conducted employing the critical incident technique. A stepwise deductive-inductive analysis was then performed.ResultsThe results reveal how co-production of care assumes different meanings according to how actors use the technology. The results also show how technology innovation changes the dynamics between the actors and rearranges care practices. Independent and safe living is co-produced through performing bricolages and optimizing practice. Additionally, this opens up for unexpected results and bricolages as an integrated part of technology innovations.ConclusionsThis study illustrates how care services are always co-produced between the actors involved. By using aspects from science and technology studies, this paper provides a framework for exploring technology in use in care practices. The framework provides tools to unpack and articulate the process of co-producing services.

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“…We experienced that the main value for participants was having the opportunity to share knowledge and experiences with others and being able to contribute to the improvement of health care. Previous research has discussed that the coproduction of public services may be experienced as both empowering and exploiting by participants [ 35 ]. How to reward participant contributions and deal with intellectual property in co-design projects is not straightforward, especially if for-profit organizations are involved in the operationalization of design ideas into products and services.…”

Section: Discussionmentioning

confidence: 99%

Co-Designing an eHealth Service for the Co-Care of Parkinson Disease: Explorative Study of Values and Challenges

et al. 2018

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BackgroundThe need for services to support patient self-care and patient education has been emphasized for patients with chronic conditions. People with chronic conditions may spend many hours per year in health and social care services, but the majority of time is spent in self-care. This has implications in how health care is best organized. The term co-care specifically stresses the combination of health care professionals’ and patients’ resources, supported by appropriate (digital) tools for information exchange, to achieve the best possible health outcomes for patients. Developers of electronic health (eHealth) services need to consider both parties’ specific needs for the service to be successful. Research on participants’ experiences of participating in co-design sessions is scarce.ObjectiveThe aim of this study was to describe different stakeholders’ (people with chronic conditions, health care professionals, and facilitators) overall experiences of participating in co-design workshops aimed at designing an eHealth service for co-care for Parkinson disease, with a particular focus on the perceptions of values and challenges of co-design as well as improvement suggestions.MethodsWe conducted 4 half-day co-design workshops with 7 people with Parkinson disease and 9 health care professionals. Data were collected during the workshop series using formative evaluations with participants and facilitators after each workshop, researchers’ diary notes throughout the co-design process, and a Web-based questionnaire after the final workshop. Quantitative data from the questionnaire were analyzed using descriptive statistics. Qualitative data were triangulated and analyzed inductively using qualitative content analysis.ResultsQuantitative ratings showed that most participants had a positive general experience of the co-design workshops. Qualitative analysis resulted in 6 categories and 30 subcategories describing respondents’ perceptions of the values and challenges of co-design and their improvement suggestions. The categories concerned (1) desire for more stakeholder variation; (2) imbalance in the collaboration between stakeholders; (3) time investment and commitment paradox; (4) desire for both flexibility and guidance; (5) relevant workshop content, but concerns about goal achievement; and (6) hopes and doubts about future care.ConclusionsBased on the identified values and challenges, some paradoxical experiences were revealed, including (1) a desire to involve more stakeholders in co-design, while preferring to work in separate groups; (2) a desire for more preparation and discussions, while the required time investment was a concern; and (3) the experience that co-design is valuable for improving care, while there are doubts about the realization of co-care in practice. The value of co-design is not mainly about creating new services; it is about improving current practices to shape better care. The choice of methods needs to be adjusted to the stakeholder group and context, which will influence how they exper...

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Co-production in chronic care: exploitation and empowerment

Cited by 28 publications

References 56 publications

Co-production in health policy and management: a comprehensive bibliometric review

Co-production in health policy and management: a comprehensive bibliometric review

Older People Negotiating Independence and Safety in Everyday Life Using Technology: Qualitative Study

Co-Designing an eHealth Service for the Co-Care of Parkinson Disease: Explorative Study of Values and Challenges

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