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Co-production in chronic care: exploitation and empowerment

Anna Essén (Center for Human Resource Management and Knowledge Work, Stockholm School of Economics, Stockholm, Sweden and Medical Management Centre, Karolinska Institutet, Stockholm, Sweden)
Sara Winterstorm Värlander (School of Business, Stockholm University, Stockholm, Sweden)
Karina T. Liljedal (Center for Consumer Marketing, Stockholm School of Economics, Stockholm, Sweden)

European Journal of Marketing

ISSN: 0309-0566

Article publication date: 9 May 2016



Many scholars have urged firms to empower consumers to become co-producers, arguing that this empowerment leads to a win-win situation that benefits consumers and providers alike. However, critical voices have emphasised that co-production is a way to exploit rather than empower consumers and hence represents a win–lose idea that benefits providers only. Regrettably, these polarised positions remain disconnected and lack empirical investigation. The aim of the present study is to move the debate beyond this stalemate by integrating these perspectives using an empirical study to explore enabling and constraining implications of the attempts to “empower” consumers.


This paper is based on a qualitative empirical study of an internationally unique example of a long-term co-production process in rheumatology care. Data were collected using both focused interviews and observations.


The study indicates that both the optimistic and the critical perspectives of co-production are valid and the implications of “empowering” consumers are two-edged.

Research Limitations/implications

The study highlights the need to zoom in and analyse how empowering and disempowering mechanisms relate to specific aspects of particular co-production processes rather than to co-production as a general phenomenon.

Practical Implications

The empirical data illustrate the feasibility of employing patients in everyday healthcare production through simple means while raising numerous issues related to, for example, traditional healthcare roles and process design.


The present study of a unique, long-term co-production illustrates how both perspectives of co-production are valid.



The authors gratefully acknowledge the generous financial support provided by the Swedish Research Council for Health, Working Life and Welfare, Grant number (FORTE 2014-4238) and the Torsten Söderberg Foundation that made this research possible.


Essén, A., Värlander, S.W. and Liljedal, K.T. (2016), "Co-production in chronic care: exploitation and empowerment", European Journal of Marketing, Vol. 50 No. 5/6, pp. 724-751.



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