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Examining Citizens’ Views on What Matters in the Allocation of Social Care Resources in the Netherlands

Year: 2026
Type: article
Abstract: Background: Demographic ageing and increased longevity are driving demand for social care. In the Netherlands, local councillors and policy advisors face complex decisions about how to allocate scarce social care resources. While local decision-makers have considerable discretion, they remain accountable to citizens. A recent study examined their views on what matters in allocating social care resources. However, little is known about citizens’ views, even though such insight is important for ensuring legitimate and responsive decision-making. Objective: To examine citizens’ views on what matters in the allocation of social care resources in the Netherlands. Methods: We conducted a Q-methodology study with 24 citizens. Participants ranked 39 statements reflecting considerations underlying decisions on the allocation of social care resources. We used factor analysis followed by varimax rotation to identify clusters in the rankings. We interpreted the clusters as viewpoints using the resulting factor arrays and qualitative data from post-ranking interviews. Results: We identified four distinct viewpoints, reflecting different value orientations: removing access barriers and autonomy; investing in social care; supporting income-based differentiation to ensure equal access; and balancing budget constraints with respect for autonomy. The viewpoints differed particularly regarding income-based differentiation, individual preferences and autonomy, and financial sustainability, while also showing agreement on several considerations. Conclusions: Citizens have different views on what matters in the allocation of social care resources, indicating that there is no single perspective to guide these decisions. At the same time, areas of agreement provide common ground that may support legitimate and responsive decision-making.
DOI: 10.31389/jltc.585
Language: English
Open Access status: diamond
OpenAlex ID: W7223182665
FWCI:
Cites: 10
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Related to: 9