International Journal of Health Policy and Management

International Journal of Health Policy and Management

Assessing Patient Participation in Health Policy Decision-Making in Cyprus

Document Type : Short Communication

Authors
Kyriakos Souliotis 1, 2
Eirini Agapidaki 2
Lily Evangelia Peppou 3
Chara Tzavara 2
George Samoutis 4
Mamas Theodorou 5
1 Faculty of Social and Political Sciences, University of Peloponnese, Corinth, Greece
2 Centre for Health Services Research, Department of Hygiene, Epidemiology and Medical Statistics, Medical School, University of Athens, Athens, Greece
3 University Mental Health Research Institute, Athens, Greece
4 Medical School, University of Nicosia, Nicosia, Cyprus
5 Faculty of Economics and Management, Open University of Cyprus, Nicosia, Cyprus
10.15171/ijhpm.2016.78
Abstract
Although the importance of patient participation in the design and evaluation of health programs and services is well-documented, there is scarcity of research with regard to patient association (PA) participation in health policy decision-making processes. To this end, the present study aimed to validate further a previously developed instrument as well as to investigate the degree of PA participation in health policy decision-making in Cyprus. A convenient sample of 114 patients-members of patients associations took part in the study. Participants were recruited from an umbrella organization, the Pancyprian Federation of Patient Associations and Friends (PFPA). PA participation in health policy decision-making was assessed with the Health Democracy Index (HDI), an original 8-item tool. To explore its psychometric properties, Cronbach α was computed as regards to its internal consistency, while its convergent validity was tested against a self-rated question enquiring about the degree of PA participation in health policy decision-making. The findings revealed that the HDI has good internal consistency and convergent validity. Furthermore, PAs were found to participate more in consultations in health-related organizations and the Ministry of Health (MoH) as well as in reforms or crucial decisions in health policy. Lower levels were documented with regard to participation in hospital boards, ethics committees in clinical trials and health technology assessment (HTA) procedures. Overall, PA participation levels were found to be lower than the mid-point of the scale. Targeted interventions aiming to facilitate patients’ involvement in health policy decision-making processes and to increase its impact are greatly needed in Cyprus.
Keywords
Patient Participation
Health Policy
Decision-Making
Subjects

  1.  

    1. Eliasoph H, Monaghan B, Beaudoin R, et al. "We are all in this together": integrated health service plans in Ontario. Healthc Q. 2007;10(3):82-87.
    2. Elwyn G, Edwards A, Mowle S, et al. Measuring the involvement of patients in shared decision-making: a systematic review of instruments. Patient Educ Couns. 2001;43(1):5-22.
    3. Arnetz JE, Winblad U, Arnetz BB, Hoglund AT. Physicians' and nurses' perceptions of patient involvement in myocardial infarction care. Eur J Cardiovasc Nurs. 2008;7(2):113-120. doi:10.1016/j.ejcnurse.2007.05.005
    4. Entwistle VA, Watt IS. Patient involvement in treatment decision-making: the case for a broader conceptual framework. Patient Educ Couns. 2006;63(3):268-278. doi:10.1016/j.pec.2006.05.002
    5. Elwyn G, O'Connor A, Stacey D, et al. Developing a quality criteria framework for patient decision aids: online international Delphi consensus process. BMJ. 2006;333(7565):417. doi:10.1136/bmj.38926.629329.AE
    6. Entwistle VA, Quick O. Trust in the context of patient safety problems. J Health Organ Manag. 2006;20(5):397-416. doi:10.1108/14777260610701786
    7. Holman H, Lorig K. Patients as partners in managing chronic disease. Partnership is a prerequisite for effective and efficient health care. BMJ. 2000;320(7234):526-527.
    8. Florin D, Dixon J. Public involvement in health care. BMJ. 2004;328(7432):159-161. doi:10.1136/bmj.328.7432.159
    9. Bieber C, Muller KG, Blumenstiel K, et al. Long-term effects of a shared decision-making intervention on physician-patient interaction and outcome in fibromyalgia. A qualitative and quantitative 1 year follow-up of a randomized controlled trial. Patient Educ Couns. 2006;63(3):357-366. doi:10.1016/j.pec.2006.05.003
    10. Bowie C, Richardson A, Sykes W. Consulting the public about health service priorities. BMJ. 1995;311(7013):1155-1158.
    11. Bowling A, Jacobson B, Southgate L. Explorations in consultation of the public and health professionals on priority setting in an inner London health district. Soc Sci Med. 1993;37(7):851-857.
    12. Bruegel RB. Patient empowerment--a trend that matters. J AHIMA. 1998;69(8):30-33.
    13. Souliotis K. Looking for Health Democracy in times of financial crisis: citizen  participation in health policy decision making. In: Souliotis K, ed. Greek I, trans. Democracy, Citizens and Health Policy. Athens, Greece: Papazisis Publications; 2014.
    14. Dicker A, Armstrong D. Patients' views of priority setting in health care: an interview survey in one practice. BMJ. 1995;311(7013):1137-1139.
    15. Goold SD, Biddle AK, Klipp G, Hall CN, Danis M. Choosing Healthplans All Together: a deliberative exercise for allocating limited health care resources. J Health Polit Policy Law. 2005;30(4):563-601.
    16. Longtin Y, Sax H, Leape LL, Sheridan SE, Donaldson L, Pittet D. Patient participation: current knowledge and applicability to patient safety. Mayo Clin Proc. 2010;85(1):53-62. doi:10.4065/mcp.2009.0248
    17. Mitton C, Smith N, Peacock S, Evoy B, Abelson J. Public participation in health care priority setting: A scoping review. Health Policy. 2009;91(3):219-228. doi:10.1016/j.healthpol.2009.01.005
    18. Oliver S, Clarke-Jones L, Rees R, et al. Involving consumers in research and development agenda setting for the NHS: developing an evidence-based approach. Health Technol Assess. 2004;8(15):1-148.
    19. Sheridan SL, Harris RP, Woolf SH. Shared decision making about screening and chemoprevention. a suggested approach from the U.S. Preventive Services Task Force. Am J Prev Med. 2004;26(1):56-66.
    20. Wiseman V, Mooney G, Berry G, Tang KC. Involving the general public in priority setting: experiences from Australia. Soc Sci Med. 2003;56(5):1001-1012.
    21. O'Connor AM, Stacey D, Entwistle V, et al. Decision aids for people facing health treatment or screening decisions. Cochrane Database Syst Rev. 2003;(2):CD001431. doi:10.1002/14651858.CD001431
    22. Legare F, O'Connor AM, Graham ID, et al. The effect of decision aids on the agreement between women's and physicians' decisional conflict about hormone replacement therapy. Patient Educ Couns. 2003;50(2):211-221.
    23. Van de Bovenkamp H, Trappenburg M. Government influence on patient organizations. Health Care Anal. 2010;19(4):329-351.
    24. Baggott R, Allsop J, Jones K. Speaking for Patient and Carers: Health Consumer Groups and the Policy Process. Hampshire: Palgrave Macmillan; 2005.
    25. Van de Bovenkamp HM, Trappenburg MJ, Grit K. Patient participation in collective health care decision-making: the Dutch model. Health Expect. 2010;13:73-85.
    26. Tyler S. Comparing the campaigning profile of maternit iser groups in Europe – can we learn anything useful? Health Expect. 2002;5:136-147.
    27. Baggott R, Forster R. Health consumer and patients’ organizations in Europe: towards a comparative analysis. Health Expect. 2008;11:85-94.
    28. Souliotis K. The concept of health democracy: documentation of a new approach in health policy decision making. The Health Democracy Index. 41 Pan Hellenic Medical Conference; 2015.
    29. Carman K, Dardess P, Maurer M, et al. Patient and family engagement: a framework for understanding the elements and developing interventions and policies. Health Aff (Millwood). 2013;32(2):223-231. doi:10.1377/hlthaff.2012.1133
    30. Sullivan M. The new subjective medicine: taking the patient's point of view on health care and health. Soc Sci Med. 2003;56(7):1595-1604.
    31. Tattersall RL. The expert patient: a new approach to chronic disease management for the twenty-first century. Clin Med. 2002;2(3):227-229.
    32. Oliver SR, Rees RW, Clarke-Jones L, et al. A multidimensional conceptual framework for analysing public involvement in health services research. Health Expect. 2008;11(1):72-84. doi:10.1111/j.1369-7625.2007.00476.x
    33. Rutter D, Manley C, Weaver T, Crawford MJ, Fulop N. Patients or partners? Case studies of user involvement in the planning and delivery of adult mental health services in London. Soc Sci Med. 2004;58(10):1973-1984. doi:10.1016/S0277-9536(03)00401-5

  • Received Date 23 November 2015
  • Revised Date 06 June 2016
  • Accepted Date 08 June 2016
  • First Published Date 01 August 2016
  • Published Date 01 August 2016