Abstract
This paper consists of an analysis of the concept of empowerment—which is often defined as a key issue in health care—at the macro, meso, and micro levels by focusing on health care reform in Belgium. Three research teams collected data and combined them in an inductive secondary analysis. Our preliminary results demonstrate that patient empowerment does not always encompass the same scientific reality. At the macro level, this concept is linked to the authorities’ wish to support at-home care for chronic patients. At the meso level, the role of caregivers in maintaining patients’ autonomy, but also the social conditions of their lives, is a salient component of empowerment. At the micro level, individual and personal features such as identity can influence patient empowerment and behavior in the health care system. This cross-level research suggests that patient empowerment is not sufficiently clearly defined at each level of the care production chain, which could impede the reform of health care. This paper underlines the polysemy of a concept viewed as a milestone in European health care policy and the necessity of a clear, collective definition to operationalize and implement it.
Highlights
The ongoing increase in chronic illness poses new challenges for European countries
The authorities have chosen to implement this joint plan through an iterative, incremental process, by launching multidisciplinary local pilot projects involving a variety of local
The contrast between meanings, and expectations, and the implementation of patient empowerment in the field is striking. The polysemy of this concept has made the implementation of patient empowerment more complex
Summary
The ongoing increase in chronic illness poses new challenges for European countries. In Belgium, more than one in four people aged 15 and over have at least one chronic condition [1]. This situation has led to an increase in health care expenditures [2,3,4]. In this context, the Belgian Government has decided to initiate a health care reform through the launch of a joint plan called “Integrated Care for Better Health” (IC4BH) [5]. Dealing with the problem of chronic diseases necessitates this kind of paradigm change. With this aim in mind, the plan (IC4BH) was structured into 20 central components, including patient empowerment [5]
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