Patients Preferred Level of Participation and Their Satisfaction in - - PowerPoint PPT Presentation

Patients’ Preferred Level of Participation and Their Satisfaction in Healthcare Decision-making

Miwa Y. Merz, Ph.D. San José State University California, USA

2020 Global Conference on Business and Finance

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What to expect

• Insights on patients’ levels of participation in the

healthcare decision-making processes and their satisfactions due to the participation

• Insights on effective communication strategy between

the physician (i.e., provider of healthcare services) and the patient (i.e., recipient or consumer of healthcare services) to encourage patients’ participation and increase their satisfaction in healthcare decision-making processes

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Content

• Introduction – 1.) why study patients’ level of

participation and their satisfaction in healthcare decision-making processes; 2.) why investigate a specific Diabetes Mellitus Type 2 (DM2) prevention context.

• Research Questions
• Literature Reviews
• Co-Creation of Value: Service Dominant (S-D) Logic
• Three levels of co-creation: physician-dominant, joint, and

patient-dominant

• Healthcare Literature and Co-Creation
• Antecedents of Co-Creation in Healthcare Service Provision
• Method
• Conclusion

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Research Questions RQ1: What are patients’ preferred level of decision- making participations across different level of co- creation (physician-dominant, joint, or patient- dominant) in the context of Diabetes Mellitus Type 2 prevention? RQ2: What are patients’ level of satisfaction when engaged in different level of co-creation (physician- dominant, joint, or patient-dominant) in the context of Diabetes Mellitus Type 2 prevention?

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U.S. Obesity Trends by State: Percent of Obese in U.S. Adults

Source: Center for Disease Control and Prevention (2015) http://www.cdc.gov/obesity/data/adult.html

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Focus on DM2 prevention is important

493,000 (1980) 1.7 million (2008) 1.4 million (2014)

Source: CDC (2015). Annual Number (in Thousands) of New Cases of Diagnosed Diabetes Among Adults Aged 18-79 Years, United States, 1980-2014. http://www.cdc.gov/diabetes/statistics/incidence/fig1.htm

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• Customers are always co-creators of value.
• Service providers do not provide value to customers, but

instead always co-create value together with their customers.

• Co-creation process is enhanced through knowledge

exchange and active interaction during the service provider-customer encounter.

• The concepts of S-D logic and consumer empowerment

both highlight the value of co-creation in healthcare context.

Anderson (1996); Angelmar & Berman (2007); Grönroos & Ravald (2010); Vargo & Lusch (2004); Vargo, Maglio, & Akaka (2008)

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Literature Review

Co-Creation of Value: Service Dominant (S-D) Logic

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Three Levels of Co-Creation in Healthcare Physician- dominant co-creation Patient- dominant co-creation Joint co-creation

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Literature Review

Three levels of co-creation in healthcare

• Physician-dominant co-creation
• Patients cooperate but do not challenge the one-way flow of

communication.

• Joint co-creation
• Two-way flow of communication takes place.
• Patients now also share past experiences, symptoms, attitudes toward

risk, values, beliefs, preferences etc.

• Patient-dominant co-creation
• Two-way flow of communication takes place.
• Physicians fully explain advantages and disadvantages of all possible

treatments.

• Information transfer from physician to patient is physician’s key

responsibility.

• Customer is encouraged to make the treatment decision.

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Healthcare Literature and Co-Creation

• Shared decision-making (Alden et al. 2012)
• Patient empowerment (Ouschan et al. 2000)
• Patient centeredness (Mead et al. 2002)
• Patient involvement (Elwyn et al. 2000)
• Patient participation (Guadoagnoli et al. 1998)
• Patient autonomy (Hayashi et al. 2000)

Value is always co-created between patients and physicians during the health service provision process.

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Healthcare Literature and Co-Creation Prior research has found that co-creation in the healthcare literature has resulted in increased:

• patient satisfaction (e.g., Kinnersley et al. 1999)
• compliance with treatments (e.g., Ouschan et al. 2000)
• health outcomes (Elwyn et al. 2000)
• etc.

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Antecedents of Co-Creation in Healthcare Decision- Makings

Merz, Czerwinski, & Merz (2013) Various antecedents exist (e.g., disease type and perceived risk) and they influence patients’ abilities and willingness to co-create, hence to participate in decision-making processes

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Diabetes Mellitus Type 2 Prevention vs. Treatment

• Extensive research on DM2 complication prevention

exists, focusing on patients with diabetes (Nothwehr & Stump, 2000; Persell et al., 2004).

• However, more research on DM2 prevention is

needed that focuses on people who have not yet developed DM2 (i.e., DM2 prevention) vs. who have developed DM2 (i.e., DM2 treatment).

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Method Experiment 1: I manipulate three levels of co-creation (physician-dominant, joint, and patient-dominant); a simple 3 factorial between-subjects design; 75-100 respondents Experiment 2: I manipulate three levels of co-creation (physician-dominant, joint, and patient-dominant), two disease contexts (DM2 prevention and treatment), and perceived risk (high vs. low); a 3x2x2 factorial between-subjects design; 150-200 respondents

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Conclusion

• Co-creation matters in the healthcare context
• Findings will help understand patients’ preferred

decision-making styles and their satisfaction based

• n disease type and perceived risk across three

levels of co-creation in Diabetes Mellitus Type 2 prevention and treatment contexts

• Findings will help physicians create more effective

healthcare services and involve patients in the decision-making processes

• Findings help patients obtain better healthcare
• utcomes and satisfaction

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Thank you for your attention! Questions or Comments? Contact Information: Miwa.Merz@sjsu.edu