Analysing information needs of decision-makers in the implementation of cost-effective innovations in mental healthcare

Summary Affordability of healthcare is currently a high priority on the political agenda. Through technological progress and the increasing healthcare demand, costs of Dutch healthcare constantly rise. Choices have to be made as to whether or not to implement a medical innovation. Since the eighties, cost-effectiveness analyses are applied increasingly for decision-making in healthcare. Generally, it aims to improve quality and increase efficiency. Although these goals are generally accepted, it seems very difficult to achieve them in practice, especially in mental healthcare. Hence, new strategies must be explored in a tight financial climate and the still increasing healthcare expenditure. Although the insufficient implementation of cost-effective innovations has been acknowledged by various parties involved (i.e. ZonMw), there is currently limited literature on how to support decision-makers in this process of implementation. In response to this, a qualitative research project was conducted to decrease the so-called gap between theory and practice in mental healthcare. By means of semi-structured in-depth interviews with stakeholders from three different decision-making levels – healthcare insurance level, healthcare institutional level and the national level – this research seeks to identify decision-maker’s information needs with respect to the implementation of cost-effective innovations. On the basis of both the literature and the interview findings, information on individual costs and revenues (i.e. budget impact, return on investment, business case) stands out as having a direct association with the implementation of cost-effective innovations. In addition, some supplemental general needs came to light during the course of this research, including appropriate financing, the presence of financial incentives and the need to generate organizational- and social support. Next to these supplemental information and general needs, it became clear that research that provides information on the cost-effectiveness of an innovation was of limited influence on choices being made. Reasons for this were the inappropriate presentation of information (i.e. individually achievable benefits were invisible) and uncertainty about the quality of information. This research, therefore, recommends the need to support decision-makers by responding to their individual (information) needs in order to improve the implementation of cost-effective innovations. In addition, direct attention should be paid to the way information is formulated and presented.