In this report, Dr John Øvretveit reviews the evidence about how involving patients more in their care can improve quality and save costs.

He examines the extent to which the published evidence on a wide range of approaches to changing patient–provider relationships supports the assertion that these approaches can both improve quality and save money.

The findings report on a field of scientific knowledge about patient–provider relationships and support for self care which is in its early stages, with more conceptual literature than empirical studies. Although there is a growing body of literature about patient–provider relations, little of it has studied the impact on costs. Even where costs are considered, these are often limited to the immediate intervention cost, rather than any assessment of return on investment in relation to the longer term costs of care. Nevertheless there are empirical studies which do provide evidence about how poor communication and lack of information impact adversely on patient care and also provide some evidence of effective interventions to improve communication and care.

The report highlights where there are gaps in the evidence and where new research could provide valuable knowledge that could help decision-makers and practitioners to make evidence-based decisions about interventions which have the most likelihood of improving quality and saving costs.

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