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How does participating in a deliberative citizens panel on healthcare priority setting influence the views of participants?

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  • Reckers-Droog, Vivian
  • Jansen, Maarten
  • Bijlmakers, Leon
  • Baltussen, Rob
  • Brouwer, Werner
  • van Exel, Job

Abstract

A deliberative citizens panel was held to obtain insight into criteria considered relevant for healthcare priority setting in the Netherlands. Our aim was to examine whether and how panel participation influenced participants’ views on this topic. Participants (n = 24) deliberated on eight reimbursement cases in September and October, 2017. Using Q methodology, we identified three distinct viewpoints before (T0) and after (T1) panel participation. At T0, viewpoint 1 emphasised that access to healthcare is a right and that prioritisation should be based solely on patients’ needs. Viewpoint 2 acknowledged scarcity of resources and emphasised the importance of treatment-related health gains. Viewpoint 3 focused on helping those in need, favouring younger patients, patients with a family, and treating diseases that heavily burden the families of patients. At T1, viewpoint 1 had become less opposed to prioritisation and more considerate of costs. Viewpoint 2 supported out-of-pocket payments more strongly. A new viewpoint 3 emerged that emphasised the importance of cost-effectiveness and that prioritisation should consider patient characteristics, such as their age. Participants’ views partly remained stable, specifically regarding equal access and prioritisation based on need and health gains. Notable changes concerned increased support for prioritisation, consideration of costs, and cost-effectiveness. Further research into the effects of deliberative methods is required to better understand how they may contribute to the legitimacy of and public support for allocation decisions in healthcare.

Suggested Citation

  • Reckers-Droog, Vivian & Jansen, Maarten & Bijlmakers, Leon & Baltussen, Rob & Brouwer, Werner & van Exel, Job, 2020. "How does participating in a deliberative citizens panel on healthcare priority setting influence the views of participants?," Health Policy, Elsevier, vol. 124(2), pages 143-151.
    • Handle: RePEc:eee:hepoli:v:124:y:2020:i:2:p:143-151
    DOI: 10.1016/j.healthpol.2019.11.011
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    1. Abelson, Julia & Eyles, John & McLeod, Christopher B. & Collins, Patricia & McMullan, Colin & Forest, Pierre-Gerlier, 2003. "Does deliberation make a difference? Results from a citizens panel study of health goals priority setting," Health Policy, Elsevier, vol. 66(1), pages 95-106, October.
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    4. Mason, Helen & van Exel, Job & Baker, Rachel & Brouwer, Werner & Donaldson, Cam, 2016. "From representing views to representativeness of views: Illustrating a new (Q2S) approach in the context of health care priority setting in nine European countries," Social Science & Medicine, Elsevier, vol. 166(C), pages 205-213.
    5. Helen Mason & Marissa Collins & Neil McHugh & Jon Godwin & Job Van Exel & Cam Donaldson & Rachel Baker, 2018. "Is “end of life” a special case? Connecting Q with survey methods to measure societal support for views on the value of life‐extending treatments," Health Economics, John Wiley & Sons, Ltd., vol. 27(5), pages 819-831, May.
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    8. Hackert, Mariska Q.N. & Brouwer, Werner B.F. & Hoefman, Renske J. & van Exel, Job, 2019. "Views of older people in the Netherlands on wellbeing: A Q-methodology study," Social Science & Medicine, Elsevier, vol. 240(C).
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    1. Rotteveel, A.H. & Reckers-Droog, V.T. & Lambooij, M.S. & de Wit, G.A. & van Exel, N.J.A., 2021. "Societal views in the Netherlands on active disinvestment of publicly funded healthcare interventions," Social Science & Medicine, Elsevier, vol. 272(C).
    2. Boxebeld, Sander & Mouter, Niek & van Exel, Job, 2025. "Public preferences for skin cancer prevention policies: a discrete choice experiment in three European countries," Social Science & Medicine, Elsevier, vol. 378(C).
    3. Rotteveel, Adriënne H. & Lambooij, Mattijs S. & van Exel, Job & de Wit, G. Ardine, 2022. "To what extent do citizens support the disinvestment of healthcare interventions? An exploration of the support for four viewpoints on active disinvestment in the Netherlands," Social Science & Medicine, Elsevier, vol. 293(C).
    4. Willem Deijl & Werner Brouwer & Job van Exel, 2023. "What Constitutes Well-being? Five Views Among Adult People from the Netherlands on what is Important for a Good Life," Applied Research in Quality of Life, Springer;International Society for Quality-of-Life Studies, vol. 18(6), pages 3141-3167, December.
    5. World Bank, 2023. "Open and Inclusive," World Bank Publications - Reports 39953, The World Bank Group.

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