title: Which experiences of health care delivery matter to service users and why? A critical interpretive synthesis and conceptual map.
abstract: OBJECTIVE
  Patients' experiences are often treated as health care quality indicators. Our aim was to identify the range of experiences of health care delivery that matter to patients and to produce a conceptual map to facilitate consideration of why they matter.
  
  
  METHODS
  Broad-based review and critical interpretive synthesis of research literature on patients' perspectives of health care delivery. We recorded experiences reported by a diverse range of patients on 'concept cards', considered why they were important, and explored various ways of organizing them, including internationally recognized health care quality frameworks. We developed a conceptual map that we refined with feedback from stakeholders.
  
  
  RESULTS
  Patients identify many health care experiences as important. Existing health care quality frameworks do not cover them all. Our conceptual map presents a rich array of experiences, including health care relationships (beyond communication) and their implications for people's valued capabilities (e.g. to feel respected, contribute to their care, experience reciprocity). It is organized to reflect our synthesis argument, which links health care delivery to what people are enabled (or not) to feel, be and do. The map highlights the broad implications of the social dynamics of health care delivery. Experiences are labelled from a patient's perspective, rendering the importance of responsiveness to individuals axiomatic.
  
  
  CONCLUSIONS
  Our conceptual map identifies and helps explain the importance of diverse experiences of health care delivery. It challenges and helps policy-makers, service providers and researchers to attend to the range of experiences that matter, and to take seriously the need for responsiveness to individuals.
authors.affiliation: Social Dimensions of Health Institute, University of Dundee, Dundee, UK. v.entwistle@cpse.dundee.ac.uk
authors.forename: Vikki
authors.initials: V
authors.lastname: Entwistle
authors.forename: Danielle
authors.initials: D
authors.lastname: Firnigl
authors.forename: Mandy
authors.initials: M
authors.lastname: Ryan
authors.forename: Jillian
authors.initials: J
authors.lastname: Francis
authors.forename: Philip
authors.initials: P
authors.lastname: Kinghorn
mesh_terms: D001294:Attitude to Health; D003210:Concept Formation; D003695:Delivery of Health Care / Q000458:organization & administration*; D006302:Health Services Research; D006801:Humans; D017060:Patient Satisfaction; D019984:Quality Indicators, Health Care