The challenge of public participation in European hospitals: a Portuguese case study

Introduction The benefits of public participation in health are widely recognised. The involvement of patients and users contributes both to the improvement of decision-making quality and to the enhancement of health services. Nevertheless, several studies have highlighted that participation remains insufficient. Methods This study is based on a literature review of participation experiences in hospitals across different European countries and on an empirical study conducted in hospitals of the Portuguese National Health Service (NHS). The analysis focused on identifying the state of the art of participation, its barriers and limitations, as well as potentialities and recommendations. Results Findings indicate that participation is largely restricted to communication and the transmission of information to users, together with consultation processes in which patients can express their preferences. However, active participation of patients and their representatives in decision-making about healthcare remains underdeveloped. Conclusion Hospitals in Europe, and particularly in Portugal, face the challenge of promoting effective participation by users and their representatives, moving beyond consultation towards meaningful involvement in healthcare decision-making.