Making care focus on patients is a way of overcoming the fragmentation that results from the “disease orientation” of Europe’s health systems, which still tend to organize around single medical specialities.
Patient-centredness increases patient satisfaction and counters the problems associated with fragmented care, such as contradictory medical advice, over prescribing, over hospitalization and unresponsiveness.
Patient-centredness requires a coordinated approach to the organization and delivery of care (and works well with integrated care initiatives).
Innovative patient-centred programmes have often been grassroots initiatives that have come about despite, not because of, national regulations.
Policy makers can foster innovation and effective collaboration by creating a supportive policy, regulatory and financial environment.
Policy makers need to address blocks to patient-centerdness at the micro, meso and macro levels and can do this by:
Providing training for patients and professionals and making health information accessible including through eHealth tools (micro or individual level action)
Developing a shared vision of patient-centredness and assigning responsibility for coordination and for fostering links between sectors (meso or organization level action)
Ensuring monitoring and quality measurement reflect expectations and by tackling legislative and regulatory blocks to patient centredness (macro or system level initiatives).
Decision makers might also consider other evidence informed measures including:
‘Care coordinator’ roles – creating focal points for people with multimorbidity
Patient-relevant outcome indicators – ensuring performance measurement systems assess more than clinical or functional outcomes
Actively promoting collaboration with social care, patient organizations and carers
Shaping process and outcome evaluations so that the review of new approaches to patient-centred care identifies the contextual factors that contribute to their success and impact.
© NIVEL and TU Berlin 2017.