Health care co-production: co-creation of value in flexible boundary spheres

Mounting pressure on governments to understand how well they can promote the health of their population is forcing national health systems to reconfigure their service delivery processes. The latest piece in the organisational puzzle is co-production: a concept that co-opts patients and informal caregivers in the self-management, realization and delivery of specific health care processes. Service management principles, especially those of value creation and co-production, acknowledge the need to engage the user and their personal network in a joint production effort. The paper supports this timely claim using the Outpatient Parenteral Antibiotic Therapy (or OPAT) illustrative case study to show how the concept of customer value-in-exchange and value-in-use applied to the successful health care co-production practice necessarily casts the patients and their informal caregivers as co-creators of value. From the theoretical perspective, the study shows how the provider sphere is not a closed dimension that limits itself to offering a value proposition. The study underlines the need for management to pay greater attention to the informal caregivers, given that these actors need to be orchestrated and that their role is set to become even more pivotal.