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Tvp20 05 omslag kijk verder

Tijdschrift voor Psychiatrie 57 (2015) 9, 672 - 679

Essay

Cost-effectiveness in Dutch mental health care: future because of ROM?

M. van Agthoven, A. van der Kolk, H. Knegtering, PH.A.E.G. Delespaul, J. Arends, P.P.T. Jeurissen, P.F.M. Krabbe, R. Huijsman, R. Luijk, E. de Beurs, L. Hakkaart-Van Roijen, R. Bruggeman

background The document reporting Dutch mental health care negotiations for 2014 - 2017 calls for a cost decrease based on cost-effectiveness. Thanks to rom, the Dutch mental health care seems well prepared for cost-effectiveness research.
aim Evaluate how valid cost-effectiveness research should be established in mental health care and the role of rom therein.
method Evaluation of requirements of cost-effectiveness research, trends, and a translation to Dutch mental health care.
results Valid cost-effectiveness research in mental health care requires the application of a societal perspective, a long time-horizon and an adequate evaluation of quality of life of patients. Healthcare consumption, outcome of care and characterisation of the patient population should be measured systematically and continuously. Currently, rom-data are not suitable to serve as a basis for cost-effectiveness research, although a proper basis is present. Further development of rom could lead to a situation in which mental health care is purchased on the basis of cost-effectiveness. However, cost-effectiveness will only really be improved if quality of care is rewarded, rather than rewarding activities that are not always related to outcome of care.
conclusion Cost-effectiveness research in mental health care should focus on societal costs and benefits, quality of life and a long time-horizon. If developed further, rom has the potential to be a basis for cost-effectiveness research in the future.

keywords cost-effectiveness, routine outcome monitoring, quality