title: Patient empowerment as a component of health system reforms: rights, benefits and vested interests.
abstract: Different strategies have been developed across countries to foster citizens' and patients' involvement, from health policies to patients' active participation in decisions regarding their health. The spectrum varies from systems where patients lead the reform of health care services, to others where a paternalistic approach still limits patients' autonomy in decision-making. This paper describes: (1) different interventions for involving patients; (2) experiences to promote consumer evidence-based advocacy; and (3) barriers to consumer involvement in health system reforms, including vested interests in patients' associations. Citizens' involvement in health systems can vary substantially, but is gaining increasing weight.
authors.affiliation: Laboratory for Medical Research and Consumer Involvement, Mario Negri Institute for Pharmacological Research, Milan, Italy.
authors.forename: Cinzia
authors.initials: C
authors.lastname: Colombo
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Moja
authors.forename: Marien
authors.initials: M
authors.lastname: Gonzalez-Lorenzo
authors.forename: Alessandro
authors.initials: A
authors.lastname: Liberati
authors.forename: Paola
authors.initials: P
authors.lastname: Mosconi
mesh_terms: D003256:Community Participation / Q000706:statistics & numerical data*; D003657:Decision Making; D003695:Delivery of Health Care / Q000458:organization & administration; D019317:Evidence-Based Medicine; D005260:Female; D018166:Health Care Reform; D006291:Health Policy; D006801:Humans; D008297:Male; D010344:Patient Advocacy / Q000706:statistics & numerical data*; D010358:Patient Participation / Q000706:statistics & numerical data*; D011209:Power, Psychological; D011787:Quality of Health Care