From 'Sovereign Self-Proclaimed Experts' to 'Impressionable Sceptics'-Developing a Patient Typology to Distinguish Patients' Interactions With Healthcare: A Qualitative Study in Germany.

Background: Person-centredness in health systems puts patients and their preferences at the centre of healthcare. However, there is not an 'one size fits all' approach as patients are heterogenous and have varying interactions with and perceptions of healthcare, and assessments of the health system performance. This study aims to explore these patient differences by (1) identifying core attributes of patients that shape their general approach to and interactions with healthcare and (2) deriving specific patient types based on these core attributes.

Methods: The qualitative study included content analysis of semi-structured, problem-oriented interviews with 27 participants selected with the aim of maximum variation and heterogeneity (e.g., regarding age, gender, health status, place of living) from the Berlin-Brandenburg region of Germany.

Results: Based on the interviews with the participants, three core patient attributes were found that shape interactions with healthcare: (1) taking care of health and illness, (2) the self-assigned patient role, and (3) the patient-assigned healthcare provider role. Seven patient types were identified across (opposing) manifestations of these core attributes, ranging from 'sovereign self-proclaimed experts' (focussing-autonomous-fulfiller) to 'impressionable sceptics' (ignoring-heteronomous-seller).

Conclusion: Consideration of the identified patient types and their different ways of engaging with healthcare providers and their varying perceptions of the health system can help to develop strategies to promote person-centredness in health systems. Furthermore, this typology can inform providers about the diverse ways in which patients may perceive healthcare interactions, and it can be useful for the training of future physicians and other healthcare professionals.