The public's voice about healthcare quality regulation policies. A population-based survey.
BACKGROUND
In the wake of various high-profile incidents in a number of countries, regulators of healthcare quality have been criticised for their 'soft' approach. In politics, concerns were expressed about public confidence. It was claimed that there are discrepancies between public opinions related to values and the values guiding regulation policies. Although the general public are final clients of regulators' work, their opinion has only been discussed in research to a limited extent. The aim of this study is to explore possible discrepancies between public values and opinions and current healthcare quality regulation policies.


METHODS
A questionnaire was submitted to 1500 members of the Dutch Healthcare Consumer Panel. Questions were developed around central ideas underlying healthcare quality regulation policies.


RESULTS
The response rate was 58.3%. The regulator was seen as being more responsible for quality of care than care providers. Patients were rated as having the least responsibility. Similar patterns were observed for the food service industry and the education sector. Complaints by patients' associations were seen as an important source of information for quality regulation, while fewer respondents trusted information delivered by care providers. However, respondents supported the regulator's imposition of lighter measures firstly.


CONCLUSIONS
There are discrepancies and similarities between public opinion and regulation policies. The discrepancies correspond to fundamental concepts; decentralisation of responsibilities is not what the public wants. There is little confidence in the regulator's use of information obtained by care providers' internal monitoring, while a larger role is seen for complaints of patient organisations. This discrepancy seems not to exist regarding the regulator's approach of imposing measures. A gradual, and often soft approach, is favoured by the majority of the public in spite of the criticism that is voiced in the media regarding this approach. Our study contributes to the limited knowledge of public opinion on government regulation policies. This knowledge is needed in order to effectively assess different approaches to involve the public in regulation policies.
NIVEL, Netherlands Institute for Health Services Research, PO Box 1568, 3500 BN, Utrecht, Netherlands. r.bouwman@nivel.nl.
Renée
R
Bouwman
NIVEL, Netherlands Institute for Health Services Research, PO Box 1568, 3500 BN, Utrecht, Netherlands. m.bomhoff@nivel.nl.
Manja
M
Bomhoff
NIVEL, Netherlands Institute for Health Services Research, PO Box 1568, 3500 BN, Utrecht, Netherlands. j.dejong@nivel.nl.
Judith D
JD
de Jong
Dutch Healthcare Inspectorate, PO box 2680, 3500 GR, Utrecht, Netherlands. pb.robben@igz.nl.|Institute of Health Policy and Management (iBMG), Erasmus University Rotterdam, PO box 1738, 3000 DR, Rotterdam, Netherlands. pb.robben@igz.nl.
Paul
P
Robben
NIVEL, Netherlands Institute for Health Services Research, PO Box 1568, 3500 BN, Utrecht, Netherlands. r.friele@nivel.nl.|TRANZO (Scientific Centre for Care and Welfare), Faculty of Social and Behavioural Sciences, Tilburg University, PO Box 90153, 5000 LE, Tilburg, Netherlands. r.friele@nivel.nl.
Roland
R
Friele
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003695:Delivery of Health Care; D005260:Female; D033161:Government Regulation; D006801:Humans; D008297:Male; D008875:Middle Aged; D011050:Policy Making; D011639:Public Opinion; D011787:Quality of Health Care / Q000331:legislation & jurisprudence*; D011795:Surveys and Questionnaires; D035502:Trust; D055815:Young Adult