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A critical analysis of national policies, systems, and structures of patient empowerment in England and Greece

Authors Boudioni M, McLaren S, Lister G

Received 15 June 2017

Accepted for publication 8 August 2017

Published 27 September 2017 Volume 2017:11 Pages 1657—1669


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 4

Editor who approved publication: Dr Johnny Chen

Markella Boudioni,1 Susan McLaren,2 Graham Lister2

1NIHR Imperial Biomedical Research Centre & Patient Experience Research Centre, Imperial College London, 2Institute for Leadership and Service Improvement, Faculty of Health and Social Care, London South Bank University, London, UK

Background: Comparison of patient empowerment (PE) policies in European countries can provide evidence for improvement and reform across different health systems. It may also influence patient and public involvement, patient experience, preference, and adherence.
Objective: The objective of this study was to compare PE within national policies, systems, and structures in England and Greece for achieving integrated people-centered health services.
Methods: We performed a critical search and review of policy and legislation papers in English and Greek languages. This included 1) general health policy and systems papers, 2) PE, patient and/or public involvement or patients’ rights policy and legislation (1990–2015), and 3) comparative or discussion papers for England and/or Greece.
Results: A total of 102 papers on PE policies, systems, and structures were identified initially; 80 papers were included, in which 46 were policy, legislative, and discussion papers about England, 21 were policy, legislation, and discussion papers about Greece, and 13 were comparative or discussion papers including both the countries. In England, National Health Service policies emphasized patient-centered services, involvement, and empowerment, with recent focus on patients’ rights; while in Greece, they emphasized patients’ rights and quality of services, with recent mentions on empowerment. The health ombudsman is a very important organization across countries; however, it may be more powerful in Greece, because of the nonexistence of local mediating bodies. Micro-structures at trusts/hospitals are comparable, but legislation gives more power to the local structures in Greece.
Conclusion: PE policies and systems have been developed and expressed differently in these countries. However, PE similarities, comparable dimensions and mechanisms, were identified. For both the countries, comparative research and these findings could be beneficial in building connections and relationships, contributing to wider European and international developments on PE, involvement, and patients’ rights and further impact on patient preferences and adherence.

Keywords: patient empowerment, patient involvement, patients’ rights, England, Greece, national health policies

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