CAN QUALITY CARE IN PSYCHIATRY BE PURCHASED

Is it feasible to purchase quality care in psychiatry through managed competition? Can representatives of the Swedish public choose wisely b etween tenders for care and hold the provider accountable? Yes, to a p oint. The parties can reasonably agree on a budget to serve a defined population, using professional guidelines and procedures for diagnosis , treatment, and follow-up. Such an agreement is likely to enhance the quality of care. It can be audited partly by means of nonspecific mul tiple indicators. Nevertheless, paying for specific patient outcomes h as the propensity to upset the care ecosystem, inviting bias and corru ption. Comparative field studies of impact of specific outcome indicat ors are recommended before the reform cycling continues.