Brussels, Belgium – In a democratic system, politicians are elected to make decisions regarding health care priorities. In deliberation-driven systems, such as in Belgium, coverage decisions are based on the outcomes of a deliberation amongst stakeholders (including public authorities, providers, academics, and sickness funds). Patients and citizens are rarely –if-ever- directly involved in this process.

Should citizens and patients be involved more intensively? If so, how?  To find out, researchers from the Belgian Health Care Knowledge Centre (KCE) performed a two-round Delphi survey on Belgian stakeholders currently involved or not (yet) involved in the decision-making processes. Eighty people participated in both rounds. The Delphi panel of participants consisted of politicians on national, regional and local level, members of advisory committees, patient organisations, and consumer organisations.

Panel participants preferred citizens and patients to be consulted within the existing structures and at particular milestones in the process. Justification should be provided when decisions deviate from the recommendation of the public or patients. The researchers feel that further research is needed regarding the effectiveness of public and patient involvement strategies.

Irina Cleemput, PhD, senior health economist, explains, “The panel reached consensus on the importance of public and patient involvement in health care coverage decisions, however, they see different roles for patients and citizens. While citizens should be involved in determining the general priorities in health care, patients should be involved in coverage decisions as experts by experience.”

The full study, “Acceptability and Perceived Benefits and Risks of Public and Patient Involvement in Health Care Policy: A Delphi Survey in Belgian Stakeholders,” is published in Value in Health.

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