Healthcare service users as resource integrators: investigating factors influencing the co-creation of value at individual, dyadic and systemic levels

Purpose: Patients, when using healthcare services, (co)create value by integrating their own resources with those of a range of stakeholders. These resource integration activities, however, require different types of skills and effort from the patients, and different types of interactions with stakeholders, while also having different effects on patients' well-being. The purpose of the present study is to develop a better understanding of why some patients are better able or willing to perform resource integration activities that impact their well-being. To reach this objective, barriers and facilitators of these activities in their interactions with various stakeholders were identified. Design/methodology/approach: The study uses a multiple case study design. Individual patients having received a lung transplant, together with their entourage (family, medical professionals, other patients) each represent a case. In-depth interviews were conducted with the patients and with various categories of stakeholders in their service delivery network who were relevant to their experience and with whom they integrated their resources. Findings: The study identifies three levels on which barriers and facilitators of the resource integration process occur: the individual, relational and systemic level. Factors on these levels affect different aspects of the process. Originality/value: This study takes a systems perspective and investigates how various systemic factors and stakeholders conduce or inhibit healthcare service users to perform resource integration activities, especially focusing on those activities that strongly affect their well-being.