Benchmarking Mental Health Care
SBG was founded in 2010 to organize and manage the nationwide collection of patient-based outcome data on Mental Health Care (MHC) in the Netherlands. SBG collects Outcome data through the nationwide implementation of Routine Outcome Monitoring (ROM). ROM involves assessment of symptomatology and functioning of patients in MHC at regular intervals and aims to enhance treatment quality by providing therapists and patients with regular feedback.
Progress towards treatment goals is monitored, which motivates the therapist to continue the chosen treatment or instigate alternative treatment options. ROM helps to involve patients more with their treatment and stimulates Shared Decision Making. Evaluation at regular intervals helps to timely conclude treatment. SBG aggregates the ROM data in a central database and provides feedback on treatment outcome of treatment providers (therapists, teams, locations, or entire institutes) for subgroups of patients with specific psychiatric disorders and combines this information with data on cost of treatment to reveal patient-based value of MHC.
In collaboration with professionals, patients and other stakeholders, outcome domains were selected and measures, casemix variables, and cost indicators. We stratified MHC in homogeneous subgroups of patients regarding, age group, diagnosis, and care needs, and devised a methodology to provide meaningful information on the quality of care.
Currently, about 50% of all 1.000.000 treatments performed yearly in Dutch mental health care have complete outcome data and a total of 2.500.000 treatments can be evaluated. Results reveal substantial practice variation between providers in outcome and costs, which is only partly accounted for by casemix differences among providers. Average outcome of therapists, teams, and institutes are made available continuously through our secured website to treatment providers as well as health insurers; the website to grant patients access to outcome data will be launched in 2018. SBG organizes several benchmarking projects for various sectors of MHC (common mental disorders, severe mental disorders, substance abuse, short basic MHC, etcetera) to stimulate use of the avaialble data.
In these projects, providers and health care insurers conjointly study the data to learn what they tell us about unwarranted variation. Providers exchange best practices and share their experiences with steps taken to improve the value of care (i.e., the balance between costs and outcome). They aim to learn from each other, and gain experience on how best practices can be implemented.
The ultimate objective is to improve patient-based value of mental healthcare across the Netherlands throught (1) supporting individual treatments with information on progress, (2) providing feedback on providers performance (effectivenss and efficiency), which is eventually intended to allow for a (3) pay-for-performance (P4P) payment system.