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Comment & Response
February 2018

Cost Sharing Does Not Lead to an Overall Increase of Involuntary Commitments in the Netherlands

Author Affiliations
  • 1Department of Psychiatry, Erasmus Medical Centre, University Medical Centre Rotterdam, the Netherlands
JAMA Psychiatry. 2018;75(2):213. doi:10.1001/jamapsychiatry.2017.3832

To the Editor In 2012, the Dutch government increased the out-of-pocket price for mental health care, aiming to achieve cost savings but possibly overlooking negative downstream consequences. Ravesteijn and colleagues1 showed that immediately after the introduction of the new cost-sharing policy, regular service use decreased by 13.4%. In contrast, acute mental health care use increased by 25.1% and involuntary commitment increased by 96.8%. The authors concluded that the higher out-of-pocket price generated aggregate savings but increased costs for acute care and involuntary commitment.

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