Presentation (CTI)

OBJECTIVES: Person-centred care (PCC) is increasingly recognised for its potential to improve outcomes and reduce healthcare costs. Recent reviews suggest PCC interventions are generally cost-effective or cost-saving compared with usual care. However, implementing PCC also demands that healthcare systems address health equity and social determinants of health (SDoH). This review explores how well existing economic evidence on PCC accounts for population subgroups defined by SDoH.
METHODS: A systematic review was conducted using free-text and MeSH terms related to PCC, costs, and benefits. Studies were included if PCC was defined as a partnership between patients and providers. Two independent reviewers performed study selection and data extraction. A narrative synthesis examined demographic characteristics and inclusion/exclusion criteria through the lens of Dahlgren and Whitehead’s SDoH framework. Subgroup analysis and equity considerations in economic outcomes were also assessed.
RESULTS: Thirty-two studies were included, mostly RCTs or quasi-experimental designs from high-income countries. Twenty-eight reported inclusion/exclusion criteria. All studies included disease-specific criteria, while 19 explicitly excluded patients based on disability, language, ethnicity, or life expectancy. Age and gender were the most frequently reported SDoH, followed by ethnicity, income, and education. Only five studies conducted subgroup analyses. Echoing recent findings, most studies reported PCC interventions to be cost-effective or cost-saving. However, none examined whether these favourable outcomes held consistently across underrepresented or socially disadvantaged groups, rendering population-level economic findings insufficient for equity-focused planning.
CONCLUSIONS: Despite growing evidence supporting the economic value of PCC, existing evaluations largely overlook SDoH. The potentially underrepresentation of vulnerable groups and lack of equity-stratified economic outcomes limit our ability to confirm patient-centered and equitable value. To address this, future economic evaluations must integrate subgroup analyses, ensuring PCC programs deliver both value and fairness for all populations.