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

Tosca G. R. Vennemann*, Ben F. M. Wijnen, Lianne Ringoir, Audry Kenter, Marja J. H. Van Bon-Martens, Rob J. M. Alessie, Jasper Nuyen

*Corresponding author for this work

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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 ((sic)3,864; 95% confidence interval [CI]: (sic)3,196-(sic)4,731) decreased compared to that during the 3 months before intake ((sic)5,220; 95% CI: (sic)4,639-(sic)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.

Original languageEnglish
Pages (from-to)139-147
Number of pages9
JournalGlobal & Regional Health Technology Assessment
Volume7
Issue number1
DOIs
Publication statusPublished - Jan-2020

Keywords

  • Costs
  • General practice mental health professionals
  • Mental disorders
  • Net benefit
  • Netherlands
  • Quality-adjusted life year

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