Introduction
The delivery of healthcare is increasingly influenced by two fundamental philosophies. The first is evidence-based healthcare, which is defined as the ‘the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients’ (Kleijnen et al., 1997; Sackett et al., 1996). However, in the past 30 years, an extensive body of literature has emerged advocating another key philosophy, which is described as patient-centred healthcare. This notion is commonly discussed in both the professional and health policy literature. This chapter will consider the nature of patient-centred healthcare, and review current research of relevance to this complex concept.
The definition of patient-centred healthcare
Despite the increasing popularity of the concept of patient-centred healthcare in the literature, there is little consensus as to its exact meaning. In fact, patient-centred healthcare has been most commonly understood in terms of its opposition to the philosophy of evidence-based healthcare (Bensing, 2000; Stewart, 2001). Evidence-based healthcare is generally based on rigorous outcomes research, characterized by the randomized controlled trial, which is itself concerned with the response of the ‘average’ patient receiving defined, conventional treatment for distinct, biomedical disorders. Evidence-based healthcare has a focus on treatments and technologies, often provided in specialist hospital settings. The style of healthcare practice engendered by this philosophy has been described as ‘doctor-centred’. This means that evidence derived from controlled outcomes research on populations is to be interpreted and applied by the professional to the care of individual patients.