Abstract
This study aims to describe how person-centred care, as a concept, has been adopted into discourse in 23 European countries in relation to their healthcare systems (Beveridge, Bismarck, out of pocket). A literature review inspired by the SPICE model, using both scientific studies (CINHAL, Medline, Scopus) and grey literature (Google), was conducted. A total of 1,194 documents from CINHAL (n=139), Medline (n=245), Scopus (n=493) and Google (n=317) were analysed for content and scope of person-centred care in each country. Countries were grouped based on healthcare systems. Results from descriptive statistics (percentage, range) revealed that person-centred care was most common in the United Kingdom (n=481, 40.3%), Sweden (n=231, 19.3%), the Netherlands (n=80, 6.7%), Northern Ireland (n=79, 6.6%) and Norway (n=61, 5.1%) compared with Poland (0.6%), Hungary (0.5%), Greece (0.4%), Latvia (0.4%) and Serbia (0%). Based on healthcare systems, seven out of ten countries with the Beveridge model used person-centred care backed by scientific literature (n=999), as opposed to the Bismarck model, which was mostly supported by grey literature (n=190). Adoption of the concept of person-centred care into discourse requires a systematic approach at the national (politicians), regional (guidelines) and local (specific healthcare settings) levels visualised by decision-making to establish a well-integrated phenomenon in Europe. Evidence-based knowledge as well as national regulations regarding person-centred care are important tools to motivate the adoption of person-centred care in clinical practice. This could be expressed by decision-making at the macro (law, mission) level, which guides the meso (policies) and micro (routines) levels to adopt the scope and content of person-centred care in clinical practice. However, healthcare systems (Beveridge, Bismarck and out-of-pocket) have different structures and missions owing to ethical approaches. The quality of healthcare supported by evidence-based knowledge enables the establishment of a well-integrated phenomenon in European healthcare. Our findings clarify those countries using the Beveridge healthcare model rank higher on accepting/adopting the concept of person-centered care in discourse. To adopt the concept of person-centred care in discourse requires a systematic approach at all levels in the organisation-from the national (politicians) and regional (guideline) to the local (specific healthcare settings) levels of healthcare.
Highlights
Previous research has highlighted the importance of healthcare organisation, content of healthcare curriculum and financial systems used in healthcare (Chenoweth et al, 2019; Gyllensten et al, 2019; Pirhonen et al, 2017, 2019; Rosengren et al, 2018)
The results are presented by country, grouped by respective healthcare systems (Beveridge, Bismarck, out of pocket) and their geographic placement in Europe
The current study describes the extent of person-centred care in 23 European countries in relation to their healthcare systems (Beveridge, Bismarck and out of pocket)
Summary
Previous research has highlighted the importance of healthcare organisation, content of healthcare curriculum and financial systems used in healthcare (Chenoweth et al, 2019; Gyllensten et al, 2019; Pirhonen et al, 2017, 2019; Rosengren et al, 2018). Research has shown that person-centred care is associated with shorter hospital stays, lower readmission rates, higher quality of care and satisfaction with healthcare (Edvardsson et al, 2011, 2014; Ekman et al, 2011, 2015); Gyllensten et al (2019), McCance et al (2013), McCormack et al (2010), Pirhonen et al (2019) These advantages have led politicians and policymakers to have an increased interest in adopting and implementing person-centred care (Swedish Agency for Health and Care Services Analysis, 2018a, b). This study highlights areas for improvement, such as the education of healthcare professionals (Rosengren et al, 2018)
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