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J Patient Saf. 2016 Nov 30. [Epub ahead of print]

Classifying Patients' Complaints for Regulatory Purposes: A Pilot Study.

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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.



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.


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


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.


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.

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