title: [Behavioural standard or coercive measure? Some considerations regarding the special issue on ROM].
abstract: BACKGROUND
  The cost of mental health care has possibly risen more than costs in other sectors of health care in the Netherlands. In an attempt to control the rising costs, new policies have been implemented that include the introduction of selective financial penalties for those in need of mental health care as well as the start of performance-based mental health care reimbursement. In order to achieve the latter goal, a nation-wide large-scale data collection was introduced based on clinical routine outcome monitoring (ROM) data, with a view to using these data for benchmarking.
  
  
  OBJECTIVE
  Closer inspection of the benchmarking efforts in terms of scientific validity.
  
  
  METHODS
  Qualitative review and analysis.
  
  
  RESULTS
  Analysis shows that the type of ROM data that is collected in the Netherlands is valid for tracking the outcomes of individual patients, but unsuitable for performance comparisons between institutions for reasons of case-mix, instrument-mix, bias and lack of sensitivity.
  
  
  CONCLUSIONS
  Attempts to introduce benchmarking based on rom will probably have a negative impact on the practice of mental health care in the Netherlands. More input from mental health professionals and scientists is required in order to identify more rational and efficient ways of spending scarce resources.
authors.affiliation: Maastricht Universitair Medisch Centrum, Postbus 616, 6200 MD (drt 12), Maastricht. j.vanos@maastrichtuniversity.nl
authors.forename: J
authors.initials: J
authors.lastname: van Os
authors.forename: R
authors.initials: R
authors.lastname: Kahn
authors.forename: D
authors.initials: D
authors.lastname: Denys
authors.forename: R A
authors.initials: RA
authors.lastname: Schoevers
authors.forename: A T F
authors.initials: AT
authors.lastname: Beekman
authors.forename: W J G
authors.initials: WJ
authors.lastname: Hoogendijk
authors.forename: A M
authors.initials: AM
authors.lastname: van Hemert
authors.forename: P P G
authors.initials: PP
authors.lastname: Hodiamont
authors.forename: F
authors.initials: F
authors.lastname: Scheepers
authors.forename: Ph A E G
authors.initials: PA
authors.lastname: Delespaul
authors.forename: A F G
authors.initials: AF
authors.lastname: Leentjens
mesh_terms: D019985:Benchmarking; D017048:Health Care Costs; D006801:Humans; D008605:Mental Health Services / Q000191:economics* / Q000592:standards*; D009426:Netherlands; D010043:Outcome and Process Assessment, Health Care; D011570:Psychiatry / Q000191:economics* / Q000592:standards*; D011787:Quality of Health Care