Patient participation in collective healthcare decision making: the Dutch model
Article first published online: 28 AUG 2009
© 2009 The Authors. Journal compilation © 2009 Blackwell Publishing Ltd
Volume 13, Issue 1, pages 73–85, March 2010
How to Cite
Van De Bovenkamp, H. M., Trappenburg, M. J. and Grit, K. J. (2010), Patient participation in collective healthcare decision making: the Dutch model. Health Expectations, 13: 73–85. doi: 10.1111/j.1369-7625.2009.00567.x
- Issue published online: 17 FEB 2010
- Article first published online: 28 AUG 2009
- Accepted for publication 13 June 2009
- collective health care;
- decision making;
- patient organizations;
- patient participation
Objective To study whether the Dutch participation model is a good model of participation.
Background Patient participation is on the agenda, both on the individual and the collective level. In this study, we focus on the latter by looking at the Dutch model in which patient organizations are involved in many formal decision-making processes. This model can be described as neo-corporatist.
Design We did 52 interviews with actors in the healthcare field, 35 of which were interviews with representatives of patient organizations and 17 with actors that involved patient organizations in their decision making.
Results Dutch patient organizations have many opportunities to participate in formal healthcare decision making and, as a result, have become institutionalized. Although there were several examples identified in which patient organizations were able to influence decision making, patient organizations remain in a dependent position, which they try to overcome through professionalization.
Discussion Although this model of participation gives patient organizations many opportunities to participate, it also causes important tensions. Many organizations cannot cope with all the participation possibilities attributed to them. This participation abundance can therefore cause redistribution effects. Furthermore, their dependent position leads to the danger of being put to instrumental use. Moreover, professionalization causes tensions concerning empowerment possibilities and representativeness.
Conclusion Although the Dutch model tries to make patient organizations an equal party in healthcare decision making, this goal is not reached in practice. It is therefore important to study more closely which subjects patients can and should contribute to, and in what way.