The excellence of patient-centered healthcare: Investigating the links between empowerment, co-creation and satisfaction
Abstract
Purpose: Nowadays, international healthcare agendas are focused on patient centeredness. Policies are aimed at improving patient’s satisfaction by enhancing patient empowerment and value co-creation. However, a comprehensive model addressing the relationships between these constructs has not so far been developed. The purpose of this paper is to develop and test a model which explains the effects of patient empowerment and value co-creation on patients’ satisfaction with the quality of the services they experience. Design/methodology/approach: The links between patient satisfaction, empowerment and value co-creation are theoretically outlined via an in-depth literature review. The resulting model is tested through a survey administered to 186 chronically ill patients. The results are analyzed through covariance-based structural equation modeling. Findings: The results show that patient empowerment positively influences value co-creation which, in turn, is positively related to patient satisfaction. In addition, the analysis reveals that patient empowerment has no direct effects on satisfaction. Research limitations/implications: Although the cross-sectional design made it possible to clearly estimate the relationships among variables, it overlooked the longitudinal dimensions of co-creation processes. Practical implications: The study provides practitioners with suggestions to design patient-centered healthcare services by leveraging on patient knowledge, participation, responsibility in care and involvement in the value-creation process. Originality/value: Over the last decade, healthcare management literature has shifted its focus from healthcare organizations to patients. The number of contributions about patient satisfaction, empowerment and value co-creation exponentially increased. However, these dimensions are often studied separately. This work advances available knowledge by clarifying and testing the relationships between these three constructs.
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OHCs can provide proper, transparent, and effective communication between stakeholders.
“In this regard, OHCs can provide a proper, transparent, and effective communication between stakeholders [82].”
From Improving the Theoretical Understanding Toward Patient-Driven Health Care Innovation Through Online Value Cocreation: Systematic Review (2020) · cites this paper as [82]
OHCs are the major source of informational, social, and emotional support for people with health problems, and members interact with other stakeholders to seek, receive, and provide these types of support.
“OHCs are the major source of informational, social, and emotional support for people with health problems, and members of such communities interact with other stakeholders to seek, receive, and provide different types of supports (informational, social, and emotional) [4,70,82].”
From Improving the Theoretical Understanding Toward Patient-Driven Health Care Innovation Through Online Value Cocreation: Systematic Review (2020) · cites this paper as [82]
Self-management is where health care organizations can enhance patient participation, supporting patients in controlling their lives.
“Self-management is where health care organizations can enhance patient participation, supporting patients in controlling their lives [82].”
From Improving the Theoretical Understanding Toward Patient-Driven Health Care Innovation Through Online Value Cocreation: Systematic Review (2020) · cites this paper as [82]
Helping patients with chronic diseases such as type 2 diabetes or asthma to self-manage their condition leads to enhanced quality of care and decreases cost and inappropriate use of health care resources.
“Helping patients with chronic diseases such as type 2 diabetes or asthma to self-manage their condition leads to enhanced quality of care and decreases cost and inappropriate use of health care resources [82].”
From Improving the Theoretical Understanding Toward Patient-Driven Health Care Innovation Through Online Value Cocreation: Systematic Review (2020) · cites this paper as [82]
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“Although Rogers ’ seminal, humanistic theory dates back to the 1940s, the ideas presented within his work have real-world relevance in the contemporary era where a wider emphasis exists on ‘ patient-centered care ’ (Tartaglione et al. 2018).”
BackgroundBizzotto, N., de Bruijn, G., & Schulz, P. J. (2025) · Health Expectations · doi:10.1111/hex.70153 · Cited by 7 · see citing works
“However, their negative perception of healthcare may have also emerged as a consequence of low literacy [131 – 135] or patient empowerment [136 – 138], as other studies suggest.”
Blockchain technology and Artificial Intelligence for value co-creation in healthcare
Cavacece, Y., Ebraico, S., Spena, T. R., Mele, C., Leone, D., Schiavone, F., & Bastone, A. (2022) · IEEE International Conference on Metrology for eXtended Reality, Artificial Intelligence and Neural Engineering (MetroXRAINE) · doi:10.1109/metroxraine54828.2022.9967567 · Cited by 6 · see citing works
Self-citationStrengths of Online Travel Agencies From the Perspective of the Digital Tourist
Navarro, M. M., Berné‐Manero, C., Campillo, M. G., & Iglesias, M. P. (2019) · Advances in marketing, customer relationship management, and e-services book series · doi:10.4018/978-1-5225-7856-7.ch010 · Cited by 6 · see citing works
Improving the registration process in a healthcare facility with lean principles
Nino, V., Martínez, K., Gomez, K., & Claudio, D. (2021) · Journal of Industrial Engineering and Management · doi:10.3926/jiem.3432 · Cited by 6 · see citing works
Cerqueiro-Pequeño, J., Casal-Guisande, M., Comesaña-Campos, A., & Bouza-Rodríguez, J.-B. (2021) · Ninth International Conference on Technological Ecosystems for Enhancing Multiculturality (TEEM'21) · doi:10.1145/3486011.3486464 · Cited by 5 · see citing works
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“Putting the patient at the centre of health services’ design and delivery (Moretta Tartaglione et al., 2018), it is intended to improve the quality of health services by ensuring the access to comprehensive health promotion and risk prevention initiatives (Delaney, 2018) both in physical healthcare…”
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Exploring antecedents and consequences of care coordinated pathways using organization routines
Prakash, G., & Srivastava, S. (2019) · International Journal of Healthcare Management · doi:10.1080/20479700.2019.1615272 · Cited by 4 · see citing works
“…management and associated follow ups Patient-centricity Sources: Marley et al., 2004; Susanti, 2015; Gabutti et al., 2017; Braun and Hadwich, 2017; Tartaglione et al., 2018 (a) The hospital staff schedules doctors in a timely and need-based manner (a) The hospital staff is honest, caring and…”
BackgroundMethodHospital Service Quality and Patient Satisfaction: A Moderating Role of Trustworthiness
Rafi, T., Khalique, M., & Siddiqui, S. H. (2020) · Journal of Accounting and Finance in Emerging Economies · doi:10.26710/jafee.v6i1.1081 · Cited by 4 · see citing works
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“Co-creation aims to meet patients’ expectations for value, satisfaction, and experience (Tartaglione et al., 2018; Osei-Frimpong & Owusu-Frimpong, 2017).”
Chtioui, A., Bouhaddou, I., & Benghabrit, A. (2025) · Logistics · doi:10.3390/logistics9020053 · Cited by 3 · see citing works
Besora‐Moreno, M., Sepúlveda, C., Queral, J., Hoevel, C. J., Pedret, A., Tarro, L., Valls, R. M., Solà, R., & Llauradó, E. (2025) · Health Expectations · doi:10.1111/hex.70187 · Cited by 3 · see citing works
“Additionally, this approach can decrease decisional conflict between practitioners and older people [4 – 6], increase patient satisfaction [7, 8] and improve their healthcare outcomes [9].”
Formisano, V., Tartaglione, A. M., Fedele, M., & Cavacece, Y. (2020) · Archivio Istituzionale della Ricerca - Università degli Studi di Cassino · doi:10.7433/s111.2020.12 · Cited by 3 · see citing works
“Second, through successful value co-creation processes, organizations can improve efficiency and efficacy, thus producing customer satisfaction (Moretta Tartaglione et al., 2018; Prahalad and Ramaswamy, 2000).”
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Exploring value-dense environment in the healthcare service delivery
Prakash, G., & Srivastava, S. (2019) · The TQM Journal · doi:10.1108/tqm-04-2019-0093 · Cited by 2 · see citing works
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Kaiser Permanente Internet of Things (IoT) Roadmap
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Wyzwania realizacji koncepcji patient empowerment w kontekście kompetencji pacjentów
Rogala, A. (2020) · e-mentor · doi:10.15219/em85.1473 · Cited by 3 · see citing works
Value Co-creation and Stakeholders’ Engagement
Toni, M., & Mattia, G. (2022) · Springer eBooks · doi:10.1007/978-3-031-16340-1_5 · Cited by 1 · see citing works
Value co-creation in education : A case study of Interspectral
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Patient organizations supporting health care and co-creating value: insights from a simulation model
Costanza, F. (2021) · International journal of organizational analysis · doi:10.1108/ijoa-03-2021-2679
The Patient Added-Value to Healthcare Delivery
(2020) · Advances in healthcare information systems and administration book series · doi:10.4018/978-1-7998-2653-8.ch003
African American Women's Willingness to Participate in Online Health Communities During COVID-19
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Patient Satisfaction towards Health Services
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Syafrizal, S., Saleh, A. A., & Zadeh, A. V. (2023) · Jurnal Manajemen Universitas Bung Hatta · doi:10.37301/jmubh.v18i2.23257
“These studies are from (Opata et al., 2020), (Liu & Jo, 2020), (Moretta Tartaglione et al., 2018) and (Grissemann & Stokburger-Sauer, 2012) & (Stokburger-Sauer et al., 2012).”
Toward an Ethical and Accountable Society
Koskinen, J. S. S., Tuikka, A.-M., Zielinski, C., Kimppa, K. K., Whitehouse, D., & Cameron, J. (2024) · IFIP advances in information and communication technology · doi:10.1007/978-3-031-50758-8_2
Blurred vision: potential and challenges of co-creation approaches for migrants' visibility
Rössl, L., Zardo, F., & Khoury, C. (2024) · Forced migration studies series · doi:10.14361/9783839469033-006
Developing A Tool To Empower The Disempowered: The Components Of The Feeling Of Home
Hegymegi, E., Haines, V., Cain, R., & Liguori, A. (2024) · Proceedings of DRS · doi:10.21606/drs.2024.321
ADHERE: a toolkit for retaining PWID living with hepatitis C in healthcare systems
Baptista‐Leite, R., Lopes, H., Franco, D., Hermenegildo, C., Clemens, T., & Brand, H. (2024) · Journal of Public Health · doi:10.1007/s10389-024-02377-x
“Worldwide, the patient is progressively set at the centre of healthcare systems, converging with public health interests and goals (Harm Reduction International 2022; Moretta Tartaglione et al. 2018).”
Simetsberger, B., Pferzinger, M., & Waiguny, M. K. J. (2025) · BMC Health Services Research · doi:10.1186/s12913-025-12635-7
“In contrast, research by Moretta Tartaglione et al. addresses patient-centered healthcare and co-creation value, respectively, patient satisfaction [9].”
InfluentialPiccardo, M. A., Zulato, E., & Guglielmetti, C. (2025) · Psychology Health & Medicine · doi:10.1080/13548506.2025.2591855
“In this way, co-creation assigns a more active and central role to patients, often resulting in enhanced treatment adherence (Moretta Tartaglione et al., 2018).”
Unexpected utilization of servicescape dimensions to support customers experiencing vulnerabilities
Sandberg, B., Hurmerinta, L., Leino, H. M., & Paananen, J. (2026) · Journal of Services Marketing · doi:10.1108/jsm-08-2025-0555
Job and Employee Satisfaction Among Healthcare Staff in a Tertiary Hospital: A Cross‐Sectional Study
Jelic, M., Ristić, A., Djoković, F., Jovanovic, V., Soldatovic, I., Šalović, B., Mandić‐Rajčević, S., & Perović, M. (2026) · Journal of Nursing Management · doi:10.1155/jonm/9983570
Patient Participation and Citizenship in Outpatient Processes: A Service Logistics Study
Dokkulab, A., Kritchanchai, D., Pirojsakul, K., & Crane, M. (2026) · Logistics · doi:10.3390/logistics10060125
“…finding that citizenship behavior showed greater explanatory importance for satisfaction than participation behavior is broadly consistent with prior research showing positive associations between value co-creation and satisfaction in both general service settings and healthcare contexts [24–26].”
Ngamsirijit, W., & Sooraksa, N. (2026) · Cogent Business & Management · doi:10.1080/23311975.2026.2725419
- Authors
- Moretta Tartaglione, A., Cavacece, Y., Cassia, F., & Russo, G.
- Affiliations
- Università degli studi di Cassino e del Lazio Meridionale (IT)
- University of Verona (IT)
- Venue
- The TQM Journal
- Publisher
- Emerald
- Published
- 2018-03-05
- Volume
- 30
- Issue
- 2
- Pages
- 153-167
- ISSN
- 0954-478X (ISSN-L)
- 1754-2731
- OpenAlex
- W2784914332
- Cited by
- 68
- References
- 72
- Citations by year
- 2026: 4 · 2025: 7 · 2024: 8 · 2023: 6 · 2022: 8 · 2021: 8 · 2020: 13 · 2019: 14
- FWCI
- 13.36
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The TQM Journal (publishedVersion)
- Archivio Istituzionale della Ricerca - Università degli Studi di Cassino (submittedVersion)
- Topics
- Health Sciences › Health Professions › General Health Professions › Patient Satisfaction in Healthcare
- Social Sciences › Business, Management and Accounting › Marketing › Service and Product Innovation
- Social Sciences › Business, Management and Accounting › Organizational Behavior and Human Resource Management › Customer Service Quality and Loyalty
- Keywords
- patient-centered care, patient empowerment, value co-creation, patient satisfaction, quality of healthcare services, chronic disease patients, patient participation, health service design
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