Understanding social participation in decision making about health coverage

Abstract

Introduction: Social participation is fundamental in making decisions about health coverage, however, it is a recent issue and still blurry in its effective implementation. The aim of this study is to develop a literature review with systematic search, about the participation of patients and population in health decision making. Methodology: During the year 2017 a literature review was carried out with a systematic search of international evidence on the participation of patients in the health coverage decision making, which was divided into two phases: 1) general search; 2) search of six specific concepts found in the general search. Forty articles of scientific evidence were reviewed in total. Results: In Phase 1, the concepts of social participation, responsibility and decisional process were defined integrally. In Phase 2, the concepts of trust, legitimacy, democracy, deliberation, transparency and representation were reviewed thoroughly. Discussion: Social participation in the health decision process fosters democracy and responsibility, makes deliberative processes transparent and legitimate, promotes human rights and the development of governmental initiatives based on the needs of the population. There are pending elements to be developed for achieving a real and effective social participation. The proposed framework seeks to facilitate the incorporation of patients in the democratic deliberation processes, which allows recognizing the benefits of the participation of patients and the population in this decision-making process on health coverage.