The Economist (Intelligence Unit) – Creating Healthy Partnerships (2019)

40

THE ROLE OF PATIENT VALUE AND PATIENT-CENTRED
CARE IN HEALTH SYSTEMS

Chapter 7: Engaging patients and patient communities one at a time

Some patients are more central than others

What patients are seeking from patient-centred care is far from monolithic. It varies by geography and

health system, says Mr Graham, with patients in wealthier countries more focused on active health

system involvement while those in less well-off states are often more interested in improving patient

safety. Similarly, in our survey, respondents from the UK weighted shared decision-making roughly

equally with outcomes that matter as the key elements of patient-centricity. In every other country,

respondents were much more likely to point to the outcomes as the leading issue.

Another interesting difference appeared—this time between those advocating around different

diseases—when we asked patient groups about what was most important for a patient-centred

experience.

For those working with people living with HIV/AIDS, the most important part of patient-centricity here

was a well-organised appointment and referral process. Those advocating around other diseases also

thought this highly relevant but added that equally important was having healthcare professionals who

are interested in what patients have to say.

Those with HIV/AIDS were much less likely to see the latter as an issue. The most likely explanation is

that the history of advocacy around HIV/AIDS means that they are much more used to being listened

to.

The ability of patients, and their representative groups, to make their voices heard certainly has a

profound effect on the extent to which health systems will treat those affected in a patient-centred

way.

A self-benchmarking survey of 1,016 groups from 84 countries conducted in 2018 by PatientView,

a consultancy that tracks patient group attitudes, found that 25% of such organisations believed

that they had an impact on health policy and a further 37% that they probably did so. However, the

differences by disease community were marked.

PatientView has found that groups advocating around some diseases, such as HIV/AIDS, have generally

been the most potent in pursuing a range of goals, while others, including neurological diseases, have

tended to rate themselves lower.^81

As Mr Sehmi explains, at an extreme, organisations working on widespread chronic diseases have

typically invested heavily in patient advocacy. They are accordingly well resourced and represented.

81 Benchmarking the Patient Movement, 2018. “The health system is aware of this and always looking over its shoulder with regard to these conditions