Patient empowerment in public healthcare funding system reform: a power network perspective

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Laguecir, Aziza | Chapman, Christopher | Gebreiter, Florian | Lemaire, Célia

Edité par CCSD ; Elsevier -

International audience. This paper examines a reform of the French healthcare system thataimed to empower patients and improve their access to care butled to various adverse consequences for patients. Specifically,already socio-economically disadvantaged groups of patientsfound their positions becoming even more precarious.Conceptually, we draw upon Emerson’s power dependencetheory and find that, rather than empowering patients, thereform resulted in private health insurance providers emerging ascritical actors and primary beneficiaries of power networkchanges. This healthcare system-level analysis highlights the needfor patients to be the direct focus of healthcare system reformand the importance of considering their position within thepower network for understanding reform outcomes. Thisattention to the power network adds to the extant theorisationon the effects of funding mechanism reform on the nature ofpatient empowerment and access to healthcare.

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