Conceptualizing person- and people centeredness in primary health care: a literature review
Keywords:Clinical effectiveness, equity, healthcare development, health promotion, health systems, outcome measurement, patient-centred care, patient empowerment, people-centred care, person-centred care, person-centred medicine, population health, primary healthc
AbstractBackground and aim: Both concepts “person” and “people” centred are explored within primary health care as defined in the declaration of Alma-Ata (1978) and the WHR 2008. They share common values like respect and features like empowerment. Among those are values like equity and social justice, the necessity to address the upstream causes of ill health , the need to integrate primary care and public health, the urge for a health systems approach and the importance of ‘social cohesion’ and the role of ‘social capital’. This review aimed to provide a relatively simple structure to understand the complex comprehensive people centred health care strategy. An understandable structure is a prerequisite to identify measurable (universal) indicators to support action at all levels of the health care system.Methods: An explorative literature review on the concepts of patient, person, people and community centred or oriented care was performed. The obtained literature was structured using a multilevel perspective and the dynamics of the Donabedian model.Results: Various features of person and people centred care were identified at the three organizational levels that influence health care quality. These levels are the micro or health service/ community level, the meso or health system level and the macro or the international level. They share the need for competent, comprehensive, collaborative, coordinated, responsive, empowering action and social justice.Conclusions: This topic should be further explored by field-work in order to explore the existence of universal processes and to develop local action strategies for person-and-people centred care.
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