Transdiagnostic Decision Tool criterium costing Mental Healthcare

In the context of rising demands and scarce resources for (mental) healthcare, it is even more important to optimise the organisation of service delivery in order to ensure that available services are used to their best effect. One policy to do so involves optimisation of patient pathways through the different layers (i.e., echelons) of the mental healthcare system in order to enhance the provision of the right treatment to the right patient at the right time. Currently, there is often a mismatch in mental health care or patients stay on a waiting list for a long time. Severe mental health patients often end up in tertiary only after a long search to appropriate care.

At ESHPM/iMTA, in close cooperation with TOPGGz (Centers of Excellence in mental health care), we developed and validated several diagnostic decision tools for adequate identification of patients with severe mental health problems who will profit from the Topclinical Care.

Recently, Frederique van Krugten successfully defended her PhD that addressed and assessed this topic. The outcome now has generated to the implementation of the so called ‘Decision Tools’ as acknowledge instrument for costing in curative mental health care, within the Zorg Prestatie Model (ZPM).

ZPM was recently introduced as a costing structure for curative mental healthcare (adult care), in which a highly specialised setting has been defined whereby a higher rate can be contracted for the setting in question provided if it has the TOPGGz seal of approval, is a PUK or a specialized PAAZ. A condition for TOPGGz is that you have the certification of approval and meet all the criteria, including the criterium in which you demonstrate, based on a scientifically validated instrument, that at least 50% of your patients have a highly specialized need for care. The current decisions tools are developed for adult care.

We are very pleased that recently, the municipal of Rotterdam granted the proposal of ESHPM (Dr. Leona Hakkaart- van Roijen & Dr. Frederique van Krugten) and ErasmusMC (Prof. Dr.  Manon Hillegers & Leontine ten Hoopen, MSc) to develop a transdiagnostic Decision Tool for children and adolescents up to 18-year. For the development and validation, we will cooperate will all relevant stakeholders in this field.


Dr. Frederique van Krugten

Associate professor

Dr. Leona Hakkaart - van Roijen

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