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This report is the product of a multi-stakeholder process launched by the King Baudouin Foundation in 2007 to examine the possibilities of improving patient participation in health-care policy.The project consisted of an inductive process in which a diverse group of stakeholders were questioned, using both individual interviews and group discussions. The results of these interviews were analysed and summarised to obtain an overview of the current debate on patient participation in Belgium.To help clarify the wealth of interview material, a number of dimensions of patient participation were distinguished, namely : participation activities, participation levels, relevant players and definition of the term ‘ patient ’. Also examined were the contextual factors liable to promote or hinder the developmentof a more participatory model in Belgium, as well as the associated risks. The analysis was structured around four basic premises, each tying patient participation to a specific goal. These were : better resource management ; higher quality care ; increased self-reliance ; and better representation of particular social players.These insights formed the basis for interaction with the wider stakeholder community in a series of multi-stakeholder dialogues. The first two sessions spawned a host of interesting thoughts on such issues as: the representation of patients who are unable to express themselves ; the need for an integrated approach (both from the policy perspective and in terms of individual patients and their various needs) ; the possibility of a self-reinforcing dynamic for making patient organisations more representative ; and the need for ‘ arbitration ’ methods as a means of moving beyond individual interests at policy level.This part of the process culminated in the stakeholder day on 12 October 2007, which generated a raft of practical proposals for improving patient participation in health-care policy. Participants gave priority to the following issues, in order of importance : the professionalisation of patient organisations (i. e. developing stable and sustainable competencies to ensure effective participation in policy) ; the representation of patient organisations at macro-level ; fostering a more participatory culture among care providers ; involving patients in assessing the quality of care ; and improving the interaction between mutual insurance companies and patients/patient organisations.The stakeholders also proposed packages of practical measures for moving the process forward. One thing that emerged very markedly was the desire to continue and intensify the process of dialogue and discussion, both in the context of patient organisations and with other stakeholders.This report therefore marks an important but temporary consolidation stage in an expanding multistakeholder dynamic. The Foundation will use the results of the project as the basis for further initiatives to improve patient participation.

Belgium --- W 84.7 Patient care planning. Progressive health care (General)

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