Jim van Os
Benchmarking in mental health: a dead end exercise disguised as ‘ROM’
Health insurers founded SGB (Stichting Benchmark GGZ) with as one of its aims to facilitate hospital value-based purchasing (VBP): a hospital will only be paid when it is able to show ‘value’, in the form of benchmark results. With this goal in mind, the SBG developed a ranking of symptom score changes. However, important questions remain regarding this VBP: To what extent is this idea supported by scientific evidence? In which way is the data analysis conducted by the health insurers, and on which results are conclusions based? Can we check this SGB data collection in some way? Additionally, does VBP lead to improvements in the GGZ, and is their evidence for the effectiveness of these changes? And, are there possible risks of this benchmarking?
A further question concerns the qualities of the benchmarking itself. It is presented as a form of Routine Outcome Monitoring (ROM), but concerns are raised regarding the increasing bureaucracy and registration pressure and the impact of this on the quality and workability of healthcare. Can we consider the SGB data collection as a valid form of Routine Outcome Monitoring? ROM is the application of a flexible forward feedback loop in treatment, based on personal treatment goals, and in that way the treatment can be adapted by shared decision making.
There are also relevant questions regarding the privacy of the SGB data collection: is the privacy of the patient data guaranteed?
Beyond the current state of affairs, are there possibilities to develop this SGB data collection approach further, to improve the value of benchmarking? To what extent is this benchmark approach able to provide a valid framework regarding the quality of health care? How can we develop a new, valid and feasible quality framework for mental health care institutions and to what extent is this framework compatible with contemporary market thinking?