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Everyday and unavoidable coproduction: exploring patient participation in the delivery of healthcare services
Author(s) -
BaimLance Abigail,
Tietz Daniel,
Lever Hazel,
Swart Madeleine,
Agins Bruce
Publication year - 2019
Publication title -
sociology of health and illness
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.146
H-Index - 97
eISSN - 1467-9566
pISSN - 0141-9889
DOI - 10.1111/1467-9566.12801
Subject(s) - coproduction , health care , thematic analysis , typology , healthcare service , framing (construction) , knowledge management , sociology , public relations , qualitative research , business , psychology , computer science , engineering , political science , social science , structural engineering , anthropology , law
The financial and capacity pressures facing healthcare systems call for new strategies to deliver high‐quality, efficient services. ‘Coproduction’ is a concept gaining recognition as an approach to create patient partnerships that enable better functioning healthcare systems. Yet, this framing obscures coproduction's ‘everyday and unavoidable’ character, already part of healthcare service delivery. This paper aims to understand these everyday and unavoidable dimensions of coproduced healthcare services by drawing upon thematic and process analyses of a 15‐month ethnography of 45 patients in three HIV clinics in New York. A ‘health practices’ approach guided exploring patients’ activities, their effects on clinical processes, and the conditions surrounding their performances. By constructing a typology of activity types – Building, Accepting, and Objecting – and tracing patients’ descriptions of activity performances, the paper shows how coproduction is forged by making and relying upon clinic‐based relationships, and for patients also with a broader human community. These dynamics reveal how patients’ bodily and temporal understandings are brought into and shape coproduced services. From these insights, we recommend that healthcare practitioners incorporate into their coproduction analytic methods and perspectives to engage patients as capable and aware individuals, who can support clinic efficiencies while producing new delivery possibilities.