3 February 2020

Leon Bijlmakers and colleagues show that Citizens who are given the opportunity to reflect and interact with each other become more modest and sympathetic to health care rationing decisions. The citizen forum identified 16 criteria that participants considered relevant and acceptable for making tough choices in health care reimbursement. These criteria and the underlying values could inform Health Technology Assessment frameworks and the process of national level decision making about the benefits package of basic health insurance.

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.

Publication
Increasing the Legitimacy of Tough Choices in Healthcare Reimbursement: Approach and Results of a Citizen Forum in The Netherlands.
Bijlmakers L, Jansen M, Boer B, van Dijk W, Groenewoud S, Zwaap J, Helderman JK, van Exel J, Baltussen R.



 

Related items


Lowlands Science call for projects

17 February 2020

Researchers pay attention! Lowlands is looking for research teams to participate in Lowlands Science 2020. It’s a great way to reach a large audience, do unique experiments with and on them, and to have a memorable experience with your colleagues.

Read more

Five ZonMw ‘Off Road’ grants for Radboudumc researchers

17 February 2020

Benoit Besson, Annemarie Boleij, Jonne Doorduin, Jorik Nonnekes and Sara Roig Merino have each received an ZonMw ‘Off Road’ grant of €100,000. The grants are intended for biomedical health researchers who dare to go off the beaten track in their search for new insights and unexpected breakthroughs.

Read more

Dutch Kidney Foundation PhD grant for Johan van der Vlag and Tom Nijenhuis

14 February 2020

Johan van der Vlag and Tom Nijenhuis, theme Renal disorders, received this grant for their joint research project “Targeting a novel paracrine signaling pathway between glomerular endothelium and podocytes to treat glomerular injury”.

Read more

Health Valley 10 - 11 - 12 March

13 February 2020

For three days, professionals from healthcare, health innovation, business, education and science will come together to share their knowledge and experiences about the healthcare of the future.

Read more

KNAW Early Career Award for Geert Litjens

13 February 2020

Twelve young researchers received the Early Career Award from KNAW on 4 february. One of them is RIHS researcher Geert Litjens. The Award is aimed at researchers in the Netherlands at the start of their career who are capable of developing innovative and original research ideas.

Read more

Interactive career day for Postdocs and PhD candidates

13 February 2020

45 Postdocs and PhD candidates attended the first Interactive career day organised by Janssen Pharmaceutica, to learn more about career perspectives and R&D activities that on the longer term can lead to ideas and potential future collaboration. 

Read more