Diffusion of person-centred care within 27 European countries – interviews with managers, officials, and researchers at the micro, meso, and macro levels
Journal of Health Organization and Management
ISSN: 1477-7266
Article publication date: 11 November 2022
Issue publication date: 4 April 2023
Abstract
Purpose
This study aimed to describe facilitators and barriers in terms of regulation and financing of healthcare due to the implementation and use of person-centred care (PCC).
Design/methodology/approach
A qualitative design was adopted, using interviews at three different levels: micro = hospital ward, meso = hospital management, and macro = national board/research. Inclusion criteria were staff working in healthcare as first line managers, hospital managers, and officials/researchers on national healthcare systems, such as Bismarck, Beveridge, and mixed/out-of-pocket models, to obtain a European perspective.
Findings
Countries, such as Great Britain and Scandinavia (Beveridge tax-based health systems), were inclined to implement and use person-centred care. The relative freedom of a market (Bismarck/mixed models) did not seem to nurture demand for PCC. In countries with an autocratic culture, that is, a high-power distance, such as Mediterranean countries, PCC was regarded as foreign and not applicable. Another reason for difficulties with PCC was the tendency for corruption to hinder equity and promote inertia in the healthcare system.
Research limitations/implications
The sample of two to three participants divided into the micro, meso, and macro level for each included country was problematic to find due to contacts at national level, a bureaucratic way of working. Some information got caught in the system, and why data collection was inefficient and ran out of time. Therefore, a variation in participants at different levels (micro, meso, and macro) in different countries occurred. In addition, only 27 out of the 49 European countries were included, therefore, conclusions regarding healthcare system are limited.
Practical implications
Support at the managerial level, together with patient rights supported by European countries' laws, facilitated the diffusion of PCC.
Originality/value
Fragmented health systems divided by separate policy documents or managerial roadmaps hindered local or regional policies and made it difficult to implement innovation as PCC. Therefore, support at the managerial level, together with patient rights supported by European countries' laws, facilitated the diffusion of PCC.
Keywords
Acknowledgements
The authors would like to acknowledge participants that shared their experience with us as well as the University of Gothenburg Centre for Person-Centred Care (GPCC), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Citation
Rosengren, K., Buttigieg, S.C., Badanta, B. and Carlstrom, E. (2023), "Diffusion of person-centred care within 27 European countries – interviews with managers, officials, and researchers at the micro, meso, and macro levels", Journal of Health Organization and Management, Vol. 37 No. 1, pp. 17-34. https://doi.org/10.1108/JHOM-02-2022-0036
Publisher
:Emerald Publishing Limited
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