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From "patient" to "person" to "people": the need for integrated, people centered health care.

Jan De Maeseneer, Chris van Weel, Lieve Daeren, Christine Leyns, Peter Decat, Pauline Boeckxstaens, Dirk Avonts, Sara Willems



Background and aim
The development of person centred care is based on the principle that each human is a unique autonomous individual, in illness as much as in health. In pursuing health care that is directed at the people the interdependence of the human beings, other living beings and their broader  environment comes forward. This paper proposes a theoretical framework which identifies the major elements of people centered care. From this framework “indicator-fields” are deducted and a first exercise to define specific indicators that could be used to assess the "people centeredness" of health systems is made. With this paper we hope to feed the debate on people-oriented care, its components and possible indicators and to contribute to the develop an instrument that assesses the actual  people centeredness of a health system.

This paper builds on a literature-based theoretical exploration of the concept, and a series of Delphi-rounds with members of the International Centre for Primary Health Care and Family Medicine – Ghent University, a WHO Collaborating Centre on PHC.

Five themes and subthemes were identified which are essential in the assessment of the people-orientation of care: people centered care is sensitive and respectful for differences while at the same time promoting basic universal rights and values (proportionate universalism); is available, accessible and affordable for all; is directed at the comprehensiveness of health care services; considers relevance and quality aspects of care, such as the responsiveness, adequacy and continuity of health care; and empowers individuals and communities through active involvement and participation. Consequently, possible indicators to measure a system’s person centeredness are proposed.   

Further systematic review of the literature and empirical research on the development of the theoretical framework and useful indicators are needed to turn this into a robust tool to support health policy setting.

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