Waiting for Health Care Services

Introduction

A new kind of patient has entered the healthcare sector (Carpman, Grant, & Simmons, 1986; Marberry, 2006; Marsh, 1993), an active one who wants to participate directly in healthcare decisions and is therefore increasingly responsible for his or her own health (Wallner, 2013). At the same time, this new patient demands service quality and person-centred care that causes a paradigm shift in the understanding of healthcare and in the definition and perception of services provided for it. One of the impacts is to move the focus of healthcare in many western societies from a paternalistic approach to a shared decision making process, in which the needs of the patient are central (Emanuel & Emanuel, 1992; Gillon, 1994). In such a setting patient-participation and informed consent are fundamental rights (Kizer, 2001). Another impact is creating a more patient-friendly environment in hospitals and at resident physicians (Mangold, Peintinger, & Kopetzki, 2010).

Increasing requirements to service quality and focusing on person-centred services have also impact on the healthcare sector as any other business sector. In healthcare patients – in this context they are the consumers – demand the right to safety, to information, to choose among alternatives, and the right to be heard (Kennedy, 1962). However, healthcare is different than the other business areas; it is a highly complex field. It is not always easy for consumers to contract or consent, sometimes because of their current health condition (e.g., in case of mentally ill patients or patients in a coma), sometimes because of the complexity of the medical situation and related diagnosis or treatment procedures.

Nevertheless, patients’ autonomy has become more important in the last few decades. The US-Institute of Medicine, for example, states patient-centeredness as one of the six aims for increasing general healthcare quality provided (Adams, Greiner, & Corrigan, 2004). The World Health Organization World Alliance for Patient Safety (2005) highlights the determinant of including patients and their family into the healthcare decisions (Pittet, Allegranzi, Storr, & Donaldson, 2005). Increasing patient participation in processes and health-related decision-making as well as the changing role of patients to consumers can improve the quality of care and through this the healthcare system in general (Longtin et al., 2010; Lancet, 2005). In the “Vienna Recommendations on Health Promoting Hospitals” from 1997, the WHO, sub-organisations, and their member states announced official documents that confirmed the same statement and furthermore claimed that it would also improve the efficiency of healthcare systems (World Health Organization [WHO], 1997; Committee on Patient Safety and Quality Improvement, 2005; General Medical Council [GMC], 2013; Nursing & Midwifery Council [NMC], 2015; Brink‐Muinen et al., 2006). About 15 years after “Vienna Recommendations”, the Austrian government has included “patient empowerment” in the on-going healthcare reform (Grazie & Wimmer-Puchinger, 2014). One of its ten targets is to increase health literacy by improving the involvement of the citizens in their own health issues.