Leon Bijlmakers1, Maarten Jansen2, Bert Boer3, Wieteke van Dijk2, Stef Groenewoud2, Jacqueline Zwaap4, Jan-Kees Helderman5, Job van Exel6, Rob Baltussen2. 1. Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands. Electronic address: leon.bijlmakers@radboudumc.nl. 2. Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands. 3. Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands. 4. Netherlands' Healthcare Institute, Diemen, The Netherlands. 5. Institute for Management Research, Radboud University, Nijmegen, The Netherlands. 6. Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands; Erasmus School of Economics, Erasmus University Rotterdam, Rotterdam, The Netherlands.
Abstract
BACKGROUND: Some studies in the Netherlands have gauged public views on principles for healthcare priority setting, but they fall short of comprehensively explaining the public disapproval of several recent reimbursement decisions. OBJECTIVE: To obtain insight into citizens' preferences and identify the criteria they would propose for decisions pertaining to the benefits package of basic health insurance. METHODS: Twenty-four Dutch citizens were selected for participation in a Citizen Forum, which involved 3 weekends. Deliberations took place in small groups and in plenary, guided by 2 moderators, on the basis of 8 preselected case studies, which participants later compared and prioritized under the premise that not all treatments can or need to be reimbursed. Participants received opportunities to inform themselves through written brochures and live interactions with 3 experts. RESULTS: The Citizen Forum identified 16 criteria for inclusion or exclusion of treatments in the benefits package; they relate to the condition (2 criteria), treatment (11 criteria), and individual characteristics of those affected by the condition (3 criteria). In most case studies, it was a combination of criteria that determined whether or not participants favored inclusion of the treatment under consideration in the benefits package. Participants differed in their opinion about the relative importance of criteria, and they had difficulty in operationalizing and trading off criteria to provide a recommendation. CONCLUSIONS: Informed citizens are prepared to make and, to a certain extent, capable of making reasoned choices about the reimbursement of health services. They realize that choices are both necessary and possible. Broad public support and understanding for making tough choices regarding the benefits package of basic health insurance is not automatic: it requires an investment.
BACKGROUND: Some studies in the Netherlands have gauged public views on principles for healthcare priority setting, but they fall short of comprehensively explaining the public disapproval of several recent reimbursement decisions. OBJECTIVE: To obtain insight into citizens' preferences and identify the criteria they would propose for decisions pertaining to the benefits package of basic health insurance. METHODS: Twenty-four Dutch citizens were selected for participation in a Citizen Forum, which involved 3 weekends. Deliberations took place in small groups and in plenary, guided by 2 moderators, on the basis of 8 preselected case studies, which participants later compared and prioritized under the premise that not all treatments can or need to be reimbursed. Participants received opportunities to inform themselves through written brochures and live interactions with 3 experts. RESULTS: The Citizen Forum identified 16 criteria for inclusion or exclusion of treatments in the benefits package; they relate to the condition (2 criteria), treatment (11 criteria), and individual characteristics of those affected by the condition (3 criteria). In most case studies, it was a combination of criteria that determined whether or not participants favored inclusion of the treatment under consideration in the benefits package. Participants differed in their opinion about the relative importance of criteria, and they had difficulty in operationalizing and trading off criteria to provide a recommendation. CONCLUSIONS: Informed citizens are prepared to make and, to a certain extent, capable of making reasoned choices about the reimbursement of health services. They realize that choices are both necessary and possible. Broad public support and understanding for making tough choices regarding the benefits package of basic health insurance is not automatic: it requires an investment.
Authors: Wija Oortwijn; Don Husereau; Julia Abelson; Edwine Barasa; Diana Dana Bayani; Vania Canuto Santos; Anthony Culyer; Karen Facey; David Grainger; Katharina Kieslich; Daniel Ollendorf; Andrés Pichon-Riviere; Lars Sandman; Valentina Strammiello; Yot Teerawattananon Journal: Int J Technol Assess Health Care Date: 2022-06-03 Impact factor: 2.406
Authors: Wija Oortwijn; Don Husereau; Julia Abelson; Edwine Barasa; Diana Dana Bayani; Vania Canuto Santos; Anthony Culyer; Karen Facey; David Grainger; Katharina Kieslich; Daniel Ollendorf; Andrés Pichon-Riviere; Lars Sandman; Valentina Strammiello; Yot Teerawattananon Journal: Value Health Date: 2022-06 Impact factor: 5.101