Exploring patient participation in reducing health-care-related safety risks

prevents misunderstandings and shapes expectations. It goes beyond the scope of this
report to present an extensive analysis of this theme, but a brief outline of some of the
general issues involved in relation to national or regional government, health insurance
companies, health institutions, health professionals and the patient and family is
presented in the sections below. 3
National or regional government
The main responsibility of government, based on international human rights standards
and/or national constitutions or bills of rights, is to create a health care system that is
fair, accessible and of good quality. The realization and implementation of every citizen’s
right to health depends to a large extent on the normative, organizational and financial
preconditions created by national or regional governments. The actual involvement of
the government in the health care system varies from country to country, ranging from
national health systems under government control, to entirely privatized health systems,
to a mixture of these models.
Either way, a strong orientation at governmental level towards internationally accepted
standards and values on the right to health care is instrumental in turning this right into
a reality. It requires sufficient financial resource allocation (which may be problematic
due to demographic and/or economic situations) and a broad range of additional policy
measures, including (but not limited to):
» introducing legislation on patients’ rights;
» initiating a monitoring or supervisory system;
» promoting the development and dissemination of standards and systems on the
quality and safety of care; and
» regulating health professional training and registration.
Importantly, government should assume responsibility for undertaking or promoting
activities such as collecting and analysing patient safety data 4 and output indicators at
national level, making the aggregated results available for comparison and improvement
activity.
Health insurance companies
Health insurance companies’ role varies from country to country. It will be limited (or
even nonexistent) in countries with a government-oriented national health system, but
private health insurance companies in systems that are more market-driven can play a
dominant role in ensuring insured citizens’ entitlements are met.
Traditionally, health insurance companies tend to focus more on the availability and
price of health care they supply and less on the quality and safety of health care they
contract. Quality and safety may profit from health insurance companies’ proactive
policies in health systems in which they deliver or contract services; this may include
3 Several other relevant parties can be identified, such as patient organizations, nongovernmental organizations and the wider
industry; they may play an important role in enhancing patients’ rights and safety in a number of countries.
4 See, for instance, the Danish act on patient safety in the health care system which came into force in 2004 (briefly described
in the section on national legislation above) (17).
Patients’ rights and patient safety
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