COST CONTROL THROUGH QUALITY IMPROVEMENT - THE NEW CHALLENGE FOR PSYCHOLOGY

If national health care reform attempts to control mental health costs by reducing the quality of services, short-term expenditure reduction may be followed by a long-term increase in overall spending. A more effective strategy would be the pursuit of maximum value-the level of quality yielding the greatest possible degree of long-term cost containment. Maximizing value involves assuring appropriate access to mental health care, achieving an optimal mix of mental health services, and increasing the efficiency and effectiveness of service delivery. Deming's approach to industrial quality improvement constitutes a useful framework for improving efficiency and effectiveness. This strategy involves identifying and meeting the needs of all mental health ''customers'' through a continuous linkage of process improvement and outcome measurement. Particularly important is clinical process standardization, which is best pursued through ongoing research and the collaboration of all interested groups.