Policy context

Increasingly, consumers expect their governments, health services and health practitioners to assist them to be:

• More informed and involved generally;
• Managing their health where possible; and
• Providing prompt, appropriate and individualised help when required.

As such, listening, shaping and responding to consumer expectations of healthcare could now be seen as a critical strategic area within healthcare policy for re-orienting health systems, services and practitioners.

Historically, issues of technical quality of care and patient adherence were seen having precedence over consumer expectations (specifically) and consumer empowerment (generally)—both were effectively seen as optional extras. In contemporary health policy, this view has changed considerably; policy makers realise technical quality and adherence cannot be achieved simply by telling people what to do. Furthermore, socio-political change and higher educational attainment within the population have meant that community expectations have risen in regard to being communicated and involved with their care.

To some extent, the internet and social media has facilitated this. There are also sound economic arguments for understanding consumer expectations and incorporating them into health policy, given that high reliance on health services without a resilient community is not financially sustainable. Unfortunately—and counterproductively—our efforts to achieve this ideal (and more responsive) health system are hampered by current environment and general continuation of the “optional extra” approach to consumer expectations and empowerment.

Within health policy, “increased consumer expectations” has become a common refrain in relation to rising health care costs, alongside population ageing, increasing burden of chronic illness, and higher-cost medical technologies.

While the latter factors have been well quantified, “consumer expectations” of healthcare systems, services and practitioners remains a nebulous construction of both evidence and stereotypes. For example, there is the common belief that older people have lower expectations of healthcare and accept “what they are given.” Evidence from the UK suggests that older people actually have higher expectations of healthcare compared to others within the community, but they are more likely than others to feel that those expectations were met and thus be satisfied with the healthcare received.

This paper will discuss how consumer expectations of healthcare can be conceptualised based on current evidence and policy environment, and how these expectations may impact on health systems, services and practitioners generally.