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Questionnaire used in the KCE research project on citizen and patient participation in reimbursement decision-making (to be published in 2013).

PART 1 – Prior experience and purpose

  • Has citizen-patient participation with regard to reimbursement decisions already been discussed in one or several groups?
  • At what occasion? When was that? Why was this? Which decision / organ was involved? What type of citizen-patient was involved?
  • What were the arguments pro and/or con?
  • What was the motivation/background for/of these arguments? Which targets were researched?  
  • What type of participation was considered? and what type was not considered ? (who, method, decision, …)
  • What were or are the conclusions regarding citizen-patient participation?
  • Is participation important for the future of our healthcare system or no?
  • If no why?
  • If yes why? Is it feasible now? What is the high-level goal that could be achieved now and in the future? What are the main obstacles?
  • What do you want to attain by including public preferences in health care decision making?


Explanation by interviewer of levels of participation: inform – consult – debate – co-decision – decision

  • What level(s) of participation would be most desirable and why?
  • What would influence this choice: the subject/type of decision? The moment in the decision-making process?
  • For each of these desired levels of intensity, what would be advantages / disadvantages?
  • From your knowledge of the different stakeholders, what is feasible now? What is feasible in the Belgian context?
  • How should such participation be organised?
  • Who could be involved :
  • Citizen? Taxpayer? Consumer? Patient? Expert?
  • From your experience, what’s the opinion of the stakeholders about the citizen-patient to involve or not to involve ?
  • Who would represent the citizen-patient ?
  • What would be your ideal scenario to involve the citizen-patient in reimbursement decisions.


  • From your experience, can you give examples of participation linked to reimbursement decisions that you know about of have witnessed? If none, is there an example you have been thinking of yourself?
  • What was positive or negative about these examples?

[Probe for more than one example. If they are giving foreign examples, we ask them how this could work in Belgium. What would be the same, what would be different.]

Systematic probing questions for all examples the respondent gives:

  • what would be better compared to a situation without participation
  • what would be negative ?
  • how would it work / be organized
  • who would be involved (who would represent the citizen-patient)
  • what barriers do you see


Based on the choice made, probe again with regard to:

  • Type of motivation for participation: democracy, equity, efficiency, …
  • Which role do citizen-patient have to take within the decision making process? The user of health services perspective (more particular) or the public policy perspective (more diffuse).

Understand the priorities :

  • what would be the most interesting to achieve at mid term? at long term?
  • what would be the easiest to get going: the way of lesser resistance?

Closing question when thanking:

  • Anything else you would like to say or stress?