Factors influencing short-term effectiveness and efficiency of the care provided by Dutch general practice mental health professionals

  • Tosca G.R. Vennemann Department of Economics, Econometrics & Finance, Faculty of Economics and Business, University of Groningen, Groningen - The Netherlands
  • Ben F.M. Wijnen Center for Economic Evaluation and Machine Learning, Trimbos Institute, Netherlands Institute of Mental Health and Addiction, Utrecht and Department of Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Centre, Maastricht - The Netherlands
  • Lianne Ringoir Care Group PoZoB, Veldhoven - The Netherlands
  • Audry Kenter General Practice Stroes & Lems, Driebergen - The Netherlands
  • Marja J.H. van Bon-Martens Center for Economic Evaluation and Machine Learning, Trimbos Institute, Netherlands Institute of Mental Health and Addiction, Utrecht - The Netherlands
  • Rob J.M. Alessie Department of Economics, Econometrics & Finance, Faculty of Economics and Business, University of Groningen, Groningen - The Netherlands
  • Jasper Nuyen Department of Reintegration and Community Care, Trimbos Institute, Netherlands Institute of Mental Health and Addiction, Utrecht - The Netherlands
Keywords: Costs, General Practice Mental Health Professionals, Mental Disorders, Net-Benefit, Netherlands, QALY

Abstract

Introduction: This study examined whether factors related to general practice mental health professionals (GP-MHPs), that is, characteristics of the professional, the function, and the care provided, were associated with short-term effectiveness and efficiency of the care provided by GP-MHPs to adults in Dutch general practice.

Methods: A prospective cohort study was conducted among 320 adults with anxiety or depressive symptoms who had an intake consultation with GP-MHPs (n = 64). Effectiveness was measured in terms of change in quality-adjusted life years (QALYs) 3 months after intake; and efficiency in terms of net monetary benefit (NMB) at 3-month follow-up. A range of GP-MHP-related predictors and patient-related confounders was considered.

Results: Patients gained on average 0.022 QALYs at 3-month follow-up. The mean total costs per patient during the 3-month follow-up period (€3,864; 95% confidence interval [CI]: €3,196-€4,731) decreased compared to that during the 3 months before intake (€5,220; 95% CI: €4,639–€5,925), resulting largely from an increase in productivity. Providing mindfulness and/or relaxation exercises was associated with QALY decrement. Having longer work experience as a GP-MHP (≥2 years) and having 10-20 years of work experience as a mental health care professional were negatively associated with NMB. Furthermore, a higher number of homework exercises tended to be related to less efficient care. Finally, being self-employed and being seconded from an organization in which primary care and mental health care organizations collaborate were related to a positive NMB, while being seconded from a mental health organization tended towards such a relationship.

Conclusions: Findings seem to imply that the care provided by GP-MHPs contributes to improving patients’ functioning. Some GP-MHP-related characteristics appear to influence short-term effectiveness and efficiency of the care provided. Further research is needed to confirm and better explain these findings and to examine longer-term effects.

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Published
2020-12-14
How to Cite
1.
Vennemann T, Wijnen B, Ringoir L, Kenter A, van Bon-MartensM, Alessie R, Nuyen J. Factors influencing short-term effectiveness and efficiency of the care provided by Dutch general practice mental health professionals. GRHTA [Internet]. 14Dec.2020 [cited 22Jan.2021];7(1):139-47. Available from: https://journals.aboutscience.eu/index.php/grhta/article/view/2028
Section
Mental Health Economics: the Netherlands experience