title: Investment in online self-evaluation tests: A theoretical approach.
abstract: BACKGROUND
  Large-scale traumatic events may burden any affected public health system with consequential charges. One major post-disaster, expense factor emerges form early psychological interventions and subsequent, posttraumatic mental health care. Due to the constant increase in mental health care costs, also post-disaster public mental health requires best possible, cost-effective care systems. Screening and monitoring the affected population might be one such area to optimize the charges.
  
  
  METHODS
  This paper analyzes the potential cost-effectiveness of monitoring a psychologically traumatized population and to motivate individuals at risk to seek early treatment. As basis for our model served Grossman's health production function, which was modified according to fundamental concepts of cost-benefit analyzes, to match the basic conditions of online monitoring strategies. We then introduce some fundamental concepts of cost-benefit analysis.
  
  
  RESULTS
  When performing cost-benefit analyses, policy makers have to consider both direct costs (caused by treatment) and indirect costs (due to non-productivity). Considering both costs sources we find that the use of Internet-based psychometric screening instruments may reduce the duration of future treatment, psychological burden and treatment costs.
  
  
  CONCLUSIONS
  The identification of individuals at risk for PTSD following a disaster may help organizations prevent both the human and the economic costs of this disease. Consequently future research on mental health issues should put more emphasis on the importance of monitoring to detect early PTSD and focus the most effective resources within early treatment and morbidity prevention.
authors.affiliation: Centre for Disaster and Military Psychiatry, University of Zurich, Zurich, Switzerland. f.degara@gmail.com.
authors.forename: Francesco
authors.initials: F
authors.lastname: de Gara
authors.forename: William T
authors.initials: WT
authors.lastname: Gallo
authors.forename: Jonathan I
authors.initials: JI
authors.lastname: Bisson
authors.forename: Jerome
authors.initials: J
authors.lastname: Endrass
authors.forename: Stefan
authors.initials: S
authors.lastname: Vetter