Stakeholder involvement in the development of national indicator sets: the example of the Dutch Consumer Quality Index.

Issue/problem: In health-care systems based on regulated competition, such as The Netherlands, consumers and health insurers need comparable information about the performance of healthcare providers in terms of effectiveness, safety and patient experiences. Without further coordination, health-care providers may have to deliver data for several sets of indicators, defined by different actors. The main challenge is to stimulate providers to be transparent about those indicators that are relevant for the government, health insurers and the public alike. This calls for the involvement of all potential stakeholders in the definition of indicator sets. Description of the problem: - when and how are stakeholders involved in the development of indicators and instruments that measure the patients’ experiences with health-care providers? - does this involvement lead to indicators and instruments that match stakeholders’ information needs? We shall address the following questions, using patient experiences as an example. Results: (effects/changes) It is possible to reach consensus about what needs to be measured. There are three phases in which a dialogue between researchers and stakeholders is vital: - the preparatory phase, when the initial policy problem is transformed into a ‘researchable’ question; - the construction phase in which abstract information needs are operationalized; - and the reporting phase in which crude data are being presented in the form of report cards, quality information or policy reports. Lessons: Stakeholder involvement is complex and time-consuming. However, the resulting standardization enables contract partners (health care providers and health insurers) to move away from discussions about the validity of indicators and instruments towards discussions about the quality of care