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Coproduction of healthcare service
  1. Maren Batalden1,
  2. Paul Batalden2,
  3. Peter Margolis3,
  4. Michael Seid3,
  5. Gail Armstrong4,
  6. Lisa Opipari-Arrigan3,
  7. Hans Hartung5
  1. 1Department of Medicine, Cambridge Health Alliance, Cambridge, Massachusetts, USA
  2. 2The Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth, Lebanon, New Hampshire, USA
  3. 3Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
  4. 4College of Nursing, University of Colorado, Aurora, Colorado, USA
  5. 5Department of Pulmonary Medicine, University Hospital Crosshouse, Kilmarnock, East Ayrshire, UK
  1. Correspondence to Dr Maren Batalden, Department of Medicine, Cambridge Health Alliance, Cambridge, MA 02139, USA; mbatalden{at}, mbatalden{at},


Efforts to ensure effective participation of patients in healthcare are called by many names—patient centredness, patient engagement, patient experience. Improvement initiatives in this domain often resemble the efforts of manufacturers to engage consumers in designing and marketing products. Services, however, are fundamentally different than products; unlike goods, services are always ‘coproduced’. Failure to recognise this unique character of a service and its implications may limit our success in partnering with patients to improve health care. We trace a partial history of the coproduction concept, present a model of healthcare service coproduction and explore its application as a design principle in three healthcare service delivery innovations. We use the principle to examine the roles, relationships and aims of this interdependent work. We explore the principle's implications and challenges for health professional development, for service delivery system design and for understanding and measuring benefit in healthcare services.

  • Healthcare quality improvement
  • Health professions education
  • Patient-centred care
  • Social sciences
  • Health services research

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