VALUE CO-CREATION AND VALUE CO-DESTRUCTION IN THE PATIENT-PROVIDER RELATIONSHIP. THE CONTRIBUTION OF THE "HEALTH LITERACY" PERSPECTIVE

Patient empowerment, patient engagement, patient involvement, and patient-centered care are popular buzzwords in the fields of health policy and health care management. However, in spite of their topicality, still little is known about the issues which concern the involvement of patients as co-producers of health care services and co-creators of value. Besides, most of the scholars are inclined to focus their attention on the intrinsic value-added ascribed to health care co-production, thus overlooking the possibility of value co-destruction which is associated with the engagement of patients in the provision of health care. This paper is aimed at conceptually exploring the ideas of value co-creation and value co-destruction in the health care service system, pointing out a link between the "health literacy" concept and the co-production of health care services. This topic is approached according to a theoretical perspective, with the eventual purposes of shedding light on two important determinants of value co-destruction and inspiring further efforts of research. In particular, value co-destruction is conceived as a two-way street, where both health care providers and patients are involved. Indeed, both of them could accidentally or intentionally contribute in the process of value destruction, undermining the positive outcomes which are usually ascribed to patient engagement. Individual health literacy and organizational health literacy are understood as two crucial tools to enhance the involvement of patients as co-creators of value and reduce the risks of value co-destruction. Adopting this point of view, conceptual and practical implications are drawn, which pave the way for further developments.