When do patients co-produce? The roles of participation resources, transaction costs, and service outcomes in health care.

Recent shifts toward patient-centered care position patients as active participants in health care delivery, yet limited empirical work explains when and why patients engage in co-production. Drawing on service-dominant logic and transaction cost theory, this study examines antecedents, constraints, and outcomes of patient co-production. Survey data from 482 U.S. patients reflecting on recent health care encounterstest a framework including patient expertise, perceived control, patient support resources, risk-taking, and benefits, with transaction costs as a moderator. Results indicate that perceived control, patient support resources, psychic benefits, and economic benefits positively influence patient co-production, whereas expertise and risk-taking do not. Transaction costs weaken the effects of perceived benefits on co-production, and co-production positively influences both patient satisfaction and repurchase intention.