Mental health problems in childhood and adolescence can have long-term consequences. Prevention and early intervention are important, which makes access to good quality mental healthcare essential. Decentralization of youth mental healthcare in the Netherlands was supposed to incentivize municipalities to focus on prevention, early detection, and early intervention. As each municipality has the possibility to organize and purchase youth care in their own way, it is likely that there is variation between (groups of) municipalities in contracting, reimbursement, pricing, and other requirements to providers. Each way of purchasing care may have (unintended) implications.
First, in this research project, the PhD student will study whether current ways of purchasing care elicit provider responses, such as responses to (perverse) financial incentives, and what the effects of these responses are on treatment and outcomes of children and adolescents with mental health problems. Second, the PhD student will investigate the impact of having a small number of contracted providers in a municipality on treatment and outcomes of children and adolescents with mental health problems, for instance as a result of market power. To study these research questions, the PhD student will use observational data and econometric techniques.
Research activities
The research activities in this PhD project will be:
1. To write a detailed research proposal that fits within the project description, outlining the societal and scientific relevance of the project as well as the steps and research required to successfully complete the PhD project;
2. Map the different purchasing schemes that exist within youth mental healthcare in the Netherlands and hypothesize which of these might lead to different provider responses that can be reliably investigated;
3. Investigate the causal relationships between the selected purchasing schemes and the mental healthcare received by children and adolescents using (large) administrative datasets or survey data and appropriate econometric techniques, such as difference-in-difference estimation or regression discontinuity designs;
4. Investigate the degree of competition among youth mental healthcare providers;
5. Investigate the (causal) relationship between the degree of competition in the youth mental-healthcare market and the mental healthcare received by children and adolescents;
6. Investigate the effect of differences in youth mental healthcare caused by different purchasing schemes or market concentration on relevant health- and socioeconomic outcomes for the affected children and adolescents.
7. Disseminating research outcomes, including writing reports, scientific publications and presentations at scientific conferences.
The supervision team consists of dr. Danielle Jansen (University Medical Center Groningen, Department of General Practice and Elderly Care Medicine and Faculty of Behavioural and Social Sciences, Department of Sociology), dr. Hermien Dijk (Faculty of Economics and Business, Department of Economics, Econometrics and Finance) and prof. Gerard van den Berg (Faculty of Economics and Business, Department of Economics, Econometrics and Finance and University Medical Center Groningen, Department of Epidemiology).
The PhD student will be employed at the Faculty of Economics and Business and enrolled in the Graduate School of Economics & Business and will attend research meetings and other activities at all three faculties.
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