The missing link to patient engagement in Italy

Abstract

Purpose The purpose of this paper is to discuss the changing patterns of users' behavior in the health care service system. Although patient engagement and health services' co-production are understood as essential ingredients in the recipe for sustainable health systems, some determinants to patient involvement are still widely neglected by both policy makers and health care professionals. Among others, inadequate health literacy performs as a significant barrier to patient empowerment. Design/methodology/approach A survey aimed at objectively measuring health literacy-related skills was administered to a random sample of 600 Italian patients. The Italian version of the Newest Vital Sign (NVS) was used to assess the ability of the respondents to deal with written health information. Moreover, the respondents were asked to self-report their ability to navigate the health system. It was presumed that inadequate health literacy as measured by the NVS is related with impaired self-reported functional, interactive, and critical health-related competencies, paving the way for the inability and the unwillingness of patients to be involved in the health care provision. Findings About half of the sample showed inadequate health literacy. However, poor NVS scores were only slightly associated with limited self-reported functional, interactive, and critical health-related competencies. In general, patients with inadequate health-related skills were not likely to be engaged in the provision of health services. Elderly, people suffering from financial deprivation and less educated individuals were found to be at special risk of living with limited health literacy. Practical implications Limited health literacy is a common and relevant issue among people dealing with the health care service system. The impaired ability to collect, process, and use health information produces barriers to patient engagement and prevents the evolution of patients' behavior toward health care co-production. Originality/value Health literacy is a widely overlooked issue in the Italian national health system. This paper contributes in shedding light on the determinants and effects of health literacy of Italian hospital patients. Besides, some insights on the validity of the methodological tools typically used to assess health-related skills are provided.

Measuring Health Literacy in Southern Italy: A cross-sectional study

“…HL has gained increasing attention in public health research, as well as health services reform processes, as an essential determinant of individual health and health service use [15,[19][20][21][22][23][24]. The evaluation of HL in Italy is important to ensure the sustainability of the healthcare service system [12,21,25].…”

Empowering Patients to Co-Create a Sustainable Healthcare Value

“…However, we agree with the SUSTAIN project in including health literacy as a dimension of patient empowerment and with a consistent part of the literature claiming that patient empowerment begins with knowledge [65] and health literacy is critical to the empowerment of patients [66][67][68][69][70][71][72][73][74] showing in some cases a direct relationship between the two concepts [22,75,76]. Moreover, some authors highlight that low health literacy creates difficulties in interacting with the healthcare professionals and understanding health information available [77][78][79][80], thus discouraging the patients' participation in the delivery of health services [81,82] and in decision-making [83].…”

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

“…Lastly, yet importantly, social sustainability is established on the individual social responsibility of those who are directly and indirectly involved in the provision of care [89]. In turn, the creation of individual social responsibility in the health care environment demands a process of empowerment [90], which is intended to enable the patients and their informal caregivers to perform as active service co-producers and value creators in the design and delivery of health services [91]. In other words, patients and informal caregiver should be engaged by health care providers in a co-producing partnership, which is aimed at minimizing the risks of resources' misuse.…”