32 people came together over three weekends to participate in a mini-audience on citizens' preferences for healthcare reimbursement.
Problems and Purpose
In order to find out about citizens' preferences for reimbursement of health care, the National Institute of Sickness and Invalidity Insurance (INAMI), the Federal Center for Health Care Expertise (KCE) organized a citizen panel on this theme in autumn 2014, in collaboration with the King Baudouin Foundation. More precisely, 32 people meet over three weekends (in Louvain from September 5 to 7, in Brussels on October 4 and 5 and in La Hulpe on November 15 and 16, 2014) to answer the following question: "How can society allocate the available budget in the fairest and most equitable way possible and what are the criteria to be taken into account for reimbursing medical care?"
Background History and Context
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Organizing, Supporting, and Funding Entities
The initiators were the National Institute of Sickness and Invalidity Insurance (INAMI) and the Federal Center for Expertise in Health Care (KCE) who asked the King Baudouin Foundation to organize the mini-public.
Participant Recruitment and Selection
The composition of the panel was the result of several steps. Initially, a survey aiming to find out the preferences of citizens in terms of reimbursement of healthcare was sent by the KCE to a panel of 20,000 Belgian citizens drawn by lot on the basis of the national register. Of the 4,810 people who took part in the survey, 100 expressed their interest in participating in the citizen panel. At the same time, additional profiles were recruited by iVox, reaching a total of 175 volunteers. Secondly, a selection of 32 panelists (16 French-speaking and 16 Dutch-speaking) was made from among these volunteers, diverse in terms of gender, age, language, residence, and professional situation.
Methods and Tools Used
What Went On: Process, Interaction, and Participation
During three weekends punctuated by analyses of concrete cases, participants move towards the development of a final report which includes the criteria and conditions that they deem important to take into account when making decisions on reimbursement of health care. During the first weekend, panelists explored the subject and transmitted their ideas and initial thoughts through brainstorming. During the second weekend, benefiting from the support of experts in the field, they articulated all these ideas in the form of a list of criteria, elements, and conditions that must find their place in the decision-making process around reimbursement of health care. Finally, during the third weekend, participants enriched and wrote this list, before presenting it to key players in the field.
At the end of the three weekends, the participants thus deliver a final report containing nineteen criteria that should be taken into account in a decision regarding the reimbursement of a new treatment and six conditions that a patient must meet so that the treatment can be reimbursed.
Influence, Outcomes, and Effects
The report is presented to key players in the field of healthcare reimbursement (eight guests, six of whom are closely involved in the decision-making process regarding healthcare reimbursements ).
Analysis and Lessons Learned
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The original submission of this case entry was adapted from Vrydagh, J., Devillers, S., Talukder, D., Jacquet, V. & Bottin, J. (2020). Les mini-publics en Belgique (2001-2018) : expériences de panels citoyens délibératifs. Courrier hebdomadaire du CRISP, 32(32-33), 5-72. https://doi.org/10.3917/cris.2477.0005. Please refer to the revision history for a detailed account of subsequent edits and additions made by the Participedia community.
 Namely Irina Cleemput (KCE), Katelijne De Nys (INAMI), Ri De Ridder (INAMI), Raf Mertens (KCE), Françoise Stryckman (Pharma.be) and François Sumkay (National Alliance of Christian mutualities - ANMC) .