Including citizens in institutional reviews: expectations and experiences from the Dutch Healthcare Inspectorate

Abstract

Background: Recent changes in the structure and policy context of \nDutch health care have placed the issue of citizen participation \nhigh on the agenda of the Dutch Healthcare Inspectorate (IGZ), \nwhich conducts quality and safety reviews in medical practices and \nhealth-care institutions. With a few exceptions, the potential role \nthat citizens can play in the regulation of health-care institutions is \noverlooked in research on patient/citizen participation in health \ncare. \nObjective: This research addressed the following question: What \nare the (political) expectations for increasing citizen participation \nin health-care regulation and how do these compare to regulators\xe2\x80\x99 \nexpectations and experiences in practice? \nDesign: Because of the largely explorative nature of this study, we \nused qualitative methods (document and web analysis, focus \ngroups and interviews) to answer this question. \nResults: Our study shows that inspectors already have experience \nwith participatory formats that lead to important information. \nThere are three areas where the IGZ is currently increasing citizen \nparticipation: (i) providing individuals with information about \ninspectorate processes and activities, (ii) including patients as \nsources of information, and (iii) formally reviewing how citizen \nparticipation is ensured by health-care institutions. In situations \nwhere the patient has the clearest overview of the whole care trajectory, \nintensive methods of participation deliver valuable information. \nConclusions: It is important to target participation activities and to \ncapitalize on existing opportunities and activities, rather than creating \nparticipation activities for the sake of participation. In this \nregard, further research on the effectiveness and efficacy of different \nparticipatory strategies is necessary