The health planning process: are consumers really in control?

Area of Science:

• Health Services Management
• Public Health Policy
• Consumer Health Advocacy

Background:

• Governing boards of Health Systems Agencies (HSAs) often include both consumers and providers.
• The composition of these boards raises questions about the extent of consumer influence and control in decision-making.
• Previous research suggests a potential imbalance of power despite numerical representation.

Purpose of the Study:

• To investigate whether a numerical majority of consumers on an HSA governing board translates to actual control over decision-making.
• To identify specific factors contributing to or hindering consumer influence within the board's dynamics.
• To understand the perceived influence of consumers, providers, and staff on the board.

Main Methods:

• The study involved an analysis of the governing board of a Health Systems Agency.
• Data was collected through perceptions and self-assessments from both consumer and provider board members.
• Key areas of focus included communication, knowledge adequacy, and feelings of intimidation.

Main Results:

• Consumers perceived significant disadvantages in communication compared to providers.
• Consumers were more likely to feel their knowledge was inadequate and to experience intimidation.
• Both consumer and provider board members estimated consumers held less than one-fourth of the board's influence, with staff perceived as most influential.

Conclusions:

• A numerical consumer majority on an HSA board does not guarantee effective consumer control.
• Disparities in communication, perceived knowledge, and confidence significantly limit consumer influence.
• Strategies to enhance consumer participation and mitigate power imbalances are crucial for equitable decision-making.