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Classifying Patients’ Complaints for Regulatory Purposes: A Pilot Study

Bouwman, Renée MSc*; Bomhoff, Manja PhD*; Robben, Paul MD, PhD†‡; Friele, Roland PhD

doi: 10.1097/PTS.0000000000000297
Original Article: PDF Only

Objectives It is assumed that classifying and aggregated reporting of patients’ complaints by regulators helps to identify problem areas, to respond better to patients and increase public accountability. This pilot study addresses what a classification of complaints in a regulatory setting contributes to the various goals.

Methods A taxonomy with a clinical, management, and relationship domain was used to systematically analyze 364 patients’ complaints received by the Dutch regulator.

Results Most complaints were about hospital care, mental health care, and elder care. About certain sectors such as emergency care, little numbers of complaints were received. The largest proportion of complaints concerned the clinical domain (51%), followed by the management domain (47%) and the relationship domain (42%).

Clinical domain complaints were more prevalent in elder care (65%) than in hospital care (56%) and mental health care (41%). In complaints about mental health care, the relationship domain was the most important (65%). The management domain was most prevalent in elder care (49%) compared with the other sectors.

Conclusions Problem areas within different health-care sectors could be identified by classifying the complaints. It provided insight in the regulator’s own practices, which are aimed at public accountability. However, there are several limitations. Aggregated analyses were not possible in sectors with low numbers of complaints. Furthermore, the information remains rather superficial, and a standardized detailed system of reporting among agencies is needed. To assess which complaints need regulatory action, an in-depth analysis, using standardized methodology and criteria, of specific complaints is needed. Improving responses to patients requires more than merely aggregated reporting of complaints.

From the *NIVEL, Netherlands Institute for Health Services Research; †Dutch Healthcare Inspectorate, Utrecht; ‡Institute of Health Policy and Management (iBMG), Erasmus University Rotterdam; and §TRANZO (Scientific Centre for Care and Welfare), Faculty of Social and Behavioural Sciences, Tilburg University, Tilburg, The Netherlands.

Correspondence: Renée Bouwman, MSc, NIVEL, Netherlands Institute for Health Services Research, PO Box 1568, 3500 BN Utrecht, The Netherlands (e-mail:

Conflict of interest: The authors report no conflict of interests.

Sources of funding: This study was funded by the Dutch Health Care Inspectorate and was carried out within the Academic Collaborative Centre on Supervision where researchers of 4 research institutes cooperate with the Inspectorate.

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