Dez. Dezember geltenden Fassung der Veränderungswert nach § 9 . werden die Wörter,,der Bundespflegesatzverordnung” gestrichen und. ordinance on hospitalisation cost rate (Bundespflegesatzverordnung) and the annual The EN Official Journal of the European Union C / report went to press on 24 April , the bond price Hospital Fees Act) and the BPflV (“Bundespflegesatzverordnung”: German National Hospital Rate.
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Mit Und Ohne Bett. Bock T, Lambert M. Interpretation of results In consideration of these limitations, no indicators of health status and social functioning of psychiatric patients in the region indicate any worsening associated with the implementation of the RPB in the long run, nor did indicators of quality of psychiatric care under conditions of the RPB indicate any worsening. The fraction of cases who responded to treatment and were discharged as improved increased significantly under the RPB.
However, the results need to be replicated in other regions in Germany or in other health systems. This article is part of the Research Topic New models of care for patients with severe mental illness — bridging in- and outpatients. Second, as the data were originally generated for administrative purposes, no special study setting, study staff or any special effect of testing procedures could come into effect.
Sociodemographic and clinical indicators of quality of psychiatric care of cases at discharge from hospital or day care before and after implementation of the Regional Psychiatry Budget RPB in the administrative District of Dithmarschen. In day care setting, the average duration of stay of patients who subscribed to the integrated care program in was Additionally, we did not analyse subgroups of various psychiatric diagnoses.
Psychiatr Prax 40 In this setting, ANOVA showed an effect of diagnosis on the length of stay in a similar way as in the inpatient setting. Final results of backward analysis of variance for day care patients. Table 1 Sociodemographic and clinical indicators of health status and social adjustment of psychiatric bundespfleegsatzverordnung at time of admission before and after implementation of the Regional Psychiatry Budget RPB in the administrative District of Dithmarschen.
The hypothesis was that this switch would correct bundeepflegesatzverordnung observed shift in the distribution of diagnostic groups in the integrated care program and thus lead to a shortening of the average length of stay when compared to the integrated care program. No influence of age could be shown.
Socio-demographic and clinical indicators of health status and social adjustment significantly improved. No selection with regard to diagnosis, regional provenance or social background took place. To avoid this potential negative effect, the legislator introduced another legal basis governing the development of new models of integrated care.
Thus we expected to counter this effect after switching to the newly introduced subscription-free model project. On the contrary, the average length of stay in this setting rose, against expectations, whereas they decreased as expected in day care setting. The district of Dithmarschen began using the capitation principle only in Psychiatr Prax 43 7: One pioneer region has been scientifically studied [ 891011 ] and has shown long-lasting improvement in the health status of the psychiatric patients in its catchment area and a significant reduction in inpatient days.
The majority are located in Schleswig-Holstein, where about one million inhabitants in six administrative districts are covered by a RPB. She currently works in the area of health services research in psychiatric disorders.
§ 6 KHEntgG – Einzelnorm
The day care department is located in the same buildings as the outpatient department, and both are located outside of the main hospital building where the inpatient sector is located. WW and JT contributed to the statistical analysis of the data and their presentation. A possible explanation could lie in the particular configuration of our hospital. Selection of Indicators We selected indicators of health status and social situations of the patients in the district as well as quality indicators of psychiatric care provided during hospital or day care stays.
Health systems in transition 16 2: J Clin Psychiatry 71 Introduction The treatment of chronic psychiatric disorders is seriously hampered by the division of the German health care system into the sectors of outpatient and inpatient acute care, rehabilitation and social support care [ 12 ].
A lump sum is allocated to a major inpatient care provider in a large region on a yearly basis. The mean number of cases per year did not differ between the period before and after implementation of the RPB, as it is an inherent part of the contract between care providers and statutory health insurances, and providers have to cover the needs of their catchment area. This result was obviously linked to the negative effect of the subscription model and the repartition of diagnoses it led to, as shown in a previous work in which possible explanations are discussed In the past few years, Germany has experimented with new models of care in order to repair the known deficits of the German psychiatric care system.
Under RPB conditions the number of voluntary admissions increased significantly and the number of cases with suicidal ideas or behaviour before admission declined significantly. The rates of day- and outpatient care were concomitantly increased 5 — 8. Male patients stayed on average 2. To describe and analyze the influence of confounding factors, a multifactorial analysis of the length of stay was made including sex, age, and diagnosis after ICD as potential explaining factors.
All documented cases who received psychiatric care at the regional hospital during the years — before implementation of the RPB were compared to all documented cases who received psychiatric care at the regional hospital during the years — under capitation principle conditions within the Regional Psychiatry Budget RPB in the administrative district of Dithmarschen Figure 1.
The provider does not need to itemise services and will not be supervised by the medical review board of the statutory health insurance companies [ 67 ]. This reduction of the average length of stay in the integrated care program and model project is in line with the results of previous studies evaluating the effect of such programs on the average duration of stay 9 Cost-effectiveness of month therapeutic assertive community treatment as part of integrated care versus standard care in patients with schizophrenia treated with quetiapine immediate release ACCESS trial.
The switch to the model project corrected this unwanted effect but failed in significantly decreasing the average length of stay when compared to standard care. Thomas Keil for his input into the discussion. We selected indicators of health status and social situations of the patients in the district as well as quality indicators of psychiatric care provided during hospital or day care stays.