Hester van Eeren

| Chapter 1 1 | 10 Common practice In Dutch youth care, interventions are mostly compared to treatment as usual. As a consequence, though treatment as usual can be proven to be effective too, it is not known which intervention is more effective when one has to choose between two evidence-based interventions. It complicates the choice for the more effective option, especially when one should decide on what works best for whom. Furthermore, when effective interventions are already available for a certain target population, the question is what the standard treatment (i.e., control condition) should be when evaluating a new treatment. Therefore, it could be worthwhile to mutually compare evidence-based interventions on their effectiveness. Reimbursement criteria Establishing the effectiveness is the second criterion when deciding which health care interventions should be reimbursed in the Netherlands, according to the ‘Trechter van Dunning’ (Busschbach & Delwel, 2010; Roscam Abbin, 1991). The necessity of care, based on the burden of disease, is the first criterion, and the cost-effectiveness is the third criterion, after which it is decided if the patient can pay the costs of care or whether it should be reimbursed by society, which is the fourth criterion (Busschbach & Delwel, 2010). When we translate these criteria to youth care, the following questions should be answered subsequently: 1) Is it necessary to treat children and adolescents with a high burden of disease, that prevents them to participate at a societal level? 2) Have the treatment options been proven effective as presented in the DEI? 3) What is the cost-effectiveness of the various treatment options?, and 4) Can the youths and their families pay the costs of these interventions themselves or should they be reimbursed by society? Thus far, research in youth care has mainly focused on the first two questions. The third and fourth question have not been given as much attention. These reimbursement decisions are, however, important in youth care, since the responsibility for the budgets available for youth care was transferred from the Dutch national government to local authorities in 2015 (Transitiebureau Jeugd, 2015). This was done to enable municipalities to develop integrated policies and to tailor youth care to local and individual situations and needs. The ultimate goal was to create more coherent, more effective, more transparent, and less expensive services for children and their families. Because of the shifting budgets, it became even more important to be able to show which interventions are available and which of them are proven to be effective and cost-effective.