Disentangling patient and public involvement in healthcare decisions:why the difference matters


Patient and public involvement has become an integral aspect of many developed health systems and is judged to be an essential driver for reform. However, little attention has been paid to the distinctions between patients and the public, and the views of patients are often seen to encompass those of the general public. Using an ideal-type approach, we analyse crucial distinctions between patient involvement and public involvement using examples from Sweden and England. We highlight that patients have sectional interests as health service users in contrast to citizens who engage as a public policy agent reflecting societal interests. Patients draw on experiential knowledge and focus on output legitimacy and performance accountability, aim at typical representativeness, and a direct responsiveness to individual needs and preferences. In contrast, the public contributes with collective perspectives generated from diversity, centres on input legitimacy achieved through statistical representativeness, democratic accountability and indirect responsiveness to general citizen preferences. Thus, using patients as proxies for the public fails to achieve intended goals and benefits of involvement. We conclude that understanding and measuring the impact of patient and public involvement can only develop with the application of a clearer comprehension of the differences.

Publication DOI: https://doi.org/10.1111/1467-9566.12483
Divisions: College of Business and Social Sciences > School of Social Sciences & Humanities > Sociology and Policy
College of Business and Social Sciences > School of Social Sciences & Humanities
College of Business and Social Sciences > School of Social Sciences & Humanities > Centre for Critical Inquiry into Society and Culture (CCISC)
Additional Information: This is the peer reviewed version of the following article: Fredriksson, M., & Tritter, J. Q. (2016). Disentangling patient and public involvement in healthcare decisions: why the difference matters. Sociology of health and illness (39)11, 95-111, which has been published in final form at 10.1111/1467-9566.12483. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving
Uncontrolled Keywords: accountability,citizen participation,legitimacy,patient and public involvement,patient empowerment,responsiveness,Health(social science),Health Policy,Public Health, Environmental and Occupational Health
Publication ISSN: 1467-9566
Last Modified: 09 Jul 2024 07:04
Date Deposited: 21 Dec 2016 15:45
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Related URLs: http://www.scop ... tnerID=8YFLogxK (Scopus URL)
PURE Output Type: Article
Published Date: 2017-01-09
Published Online Date: 2016-11-11
Accepted Date: 2016-11-11
Authors: Fredriksson, Mio
Tritter, Jonathan Q. (ORCID Profile 0000-0002-1651-2428)



Version: Accepted Version

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