Grant: Commonwealth Fund Dissemination Award 2015-2016

Engaging patients had been proposed to improve health outcomes and improve health care quality. However, it is unclear whether the practice of patient engagement may be sensitive to jurisdiction-level contexts and whether there are multiple pathways to engage patients. This study aims to test the influence of contexts and identify potential intervention priorities that relate to better health outcomes. To study how patient engagement interact and connect to each other, The objective of this study is to test 1) whether there is a patient engagement network that comprises these factors, 2) whether patient engagement is sensitive to contexts, especially health care systems or jurisdictions, and 3) what are the potential intervention priorities that relate to better health care delivery and outcomes. Through network modelling, this is the first study to use cross-jurisdictional data to show multiple pathways to achieve patient engagement. The finding is that patient engagement is linked to health systems and patient characteristics and the effectiveness of engagement is modified by settings, especially specialist care or chronic illness care. The network perspective is particularly useful to 1) search for the upstream interventions or contexts that may have extensive influence over patient engagement and health outcomes and 2) set priories to engage patients without leading to self-conflicting results.