Institute of Health and Care Sciences, University of Gothenburg, Goteborg, Sweden.
J Health Organ Manag. 2021 Sep 13;35(9):265-280. doi: 10.1108/JHOM-01-2021-0008.
This study aims to describe how person-centred care, as a concept, has been adopted into discourse in 23 European countries in relation to their healthcare systems (Beveridge, Bismarck, out of pocket).
DESIGN/METHODOLOGY/APPROACH: A literature review inspired by the SPICE model, using both scientific studies (CINHAL, Medline, Scopus) and grey literature (Google), was conducted. A total of 1,194 documents from CINHAL ( = 139), Medline ( = 245), Scopus ( = 493) and Google ( = 317) were analysed for content and scope of person-centred care in each country. Countries were grouped based on healthcare systems.
Results from descriptive statistics (percentage, range) revealed that person-centred care was most common in the United Kingdom ( = 481, 40.3%), Sweden ( = 231, 19.3%), the Netherlands ( = 80, 6.7%), Northern Ireland ( = 79, 6.6%) and Norway ( = 61, 5.1%) compared with Poland (0.6%), Hungary (0.5%), Greece (0.4%), Latvia (0.4%) and Serbia (0%). Based on healthcare systems, seven out of ten countries with the Beveridge model used person-centred care backed by scientific literature ( = 999), as opposed to the Bismarck model, which was mostly supported by grey literature ( = 190).
Adoption of the concept of person-centred care into discourse requires a systematic approach at the national (politicians), regional (guidelines) and local (specific healthcare settings) levels visualised by decision-making to establish a well-integrated phenomenon in Europe.
Evidence-based knowledge as well as national regulations regarding person-centred care are important tools to motivate the adoption of person-centred care in clinical practice. This could be expressed by decision-making at the macro (law, mission) level, which guides the meso (policies) and micro (routines) levels to adopt the scope and content of person-centred care in clinical practice. However, healthcare systems (Beveridge, Bismarck and out-of-pocket) have different structures and missions owing to ethical approaches. The quality of healthcare supported by evidence-based knowledge enables the establishment of a well-integrated phenomenon in European healthcare.
ORIGINALITY/VALUE: Our findings clarify those countries using the Beveridge healthcare model rank higher on accepting/adopting the concept of person-centered care in discourse. To adopt the concept of person-centred care in discourse requires a systematic approach at all levels in the organisation-from the national (politicians) and regional (guideline) to the local (specific healthcare settings) levels of healthcare.
本研究旨在描述以人为主的关怀理念在 23 个欧洲国家的医疗体系中是如何被纳入讨论的（贝弗里奇、俾斯麦、自费）。
设计/方法/方法：受 SPICE 模型的启发，进行了文献综述，同时使用了科学研究（CINHAL、Medline、Scopus）和灰色文献（Google）。对来自 CINHAL（=139）、Medline（=245）、Scopus（=493）和 Google（=317）的 1194 份文件进行了内容和范围分析，以了解每个国家以人为主的关怀。根据医疗保健系统对国家进行分组。
描述性统计（百分比、范围）的结果显示，在英国（=481，40.3%）、瑞典（=231，19.3%）、荷兰（=80，6.7%）、北爱尔兰（=79，6.6%）和挪威（=61，5.1%），以人为主的关怀比波兰（0.6%）、匈牙利（0.5%）、希腊（0.4%）、拉脱维亚（0.4%）和塞尔维亚（0%）更为常见。根据医疗保健系统，十种采用贝弗里奇模式的国家中有七种采用了以科学文献为依据的以人为主的关怀（=999），而俾斯麦模式则主要以灰色文献为依据（=190）。
在国家（政治家）、地区（准则）和地方（特定医疗保健环境）层面上采用以人为主的关怀理念，需要有一个系统的方法，通过决策来实现这一理念，以便在欧洲建立一个良好整合的现象。
循证知识以及关于以人为主的关怀的国家法规是将以人为主的关怀理念在临床实践中付诸实践的重要工具。这可以通过宏观（法律、使命）层面的决策来表达，该决策指导中观（政策）和微观（常规）层面在临床实践中采用以人为主的关怀的范围和内容。然而，医疗保健系统（贝弗里奇、俾斯麦和自费）由于伦理方法的不同，具有不同的结构和使命。循证知识支持的医疗保健质量能够在欧洲医疗保健中建立一个良好整合的现象。
创新性/价值：我们的研究结果表明，那些采用贝弗里奇医疗模式的国家在接受/采用以人为主的关怀理念方面排名更高。要在话语中采用以人为主的关怀理念，需要在组织的各个层面上采取系统的方法，从国家（政治家）和地区（准则）到地方（特定医疗保健环境）的医疗保健层面。
