Duran Mit Und Ohne Bett. A possible explanation could lie in the particular configuration of our hospital. Detailed psychopathological documentation from the psychiatric department was not used for analysis, as parameters and their categories changed over time, as did the validity of documentation. The average length of stay for all these groups were calculated and compared. Psychiatry, 05 October https: Conclusion Under the capitation principle of the RPB, providers were better able to provide flexible and continuous care for psychiatric patients in need of inpatient treatment than was possible under the standard reimbursement model, based on single inpatient cases.
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Vudoshakar Mit Und Ohne Bundespflegesatzverordhung. Inall patients insured by both cooperating companies were included in the model project, without the need to subscribe.
Hundespflegesatzverordnung members are often reluctant to engage in new models of care that imply such a profound change in the definition and practice of inpatient psychiatric care. As we performed a pre-post comparison, there are several threats to the internal validity of the analysis.
For example, the employment situation in Germany has generally improved during the last decade [ 19 ]. Discussion Under the capitation principle of a Regional Psychiatry Budget, the mean duration of inpatient treatment of psychiatric cases could be significantly reduced and shifted to day care and outpatient settings.
No bundespfflegesatzverordnung with regard to diagnosis, regional provenance or social background took place. Methods Study Design The study used a bundespflegsatzverordnung comparison design. Such a change is often seen by staff members as a challenge to their ability bundespflegewatzverordnung take care of acutely ill patients and to offer them comprehensive treatment.
A possible explanation for the lack of effect from the switch to the model project in the day care setting can be found when analyzing the diagnostic repartition of patients in both groups: Data regarding the effects of integrated care projects bundespflegesatzverotdnung regional budgets on clinical and financial outcomes are, to date, scarce.
Also, it cannot be excluded that cases are shifted into outpatient care delivered by the Association of Statutory Health Insurance Physicians, that does not belong to the RPB, but is unlikely to accept additional cases due to own limited budget. Health systems in transition 16 2: The first initiative took the form of regional budgets.
The bundespflegesatzverrodnung 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 ]. Improved documentation of therapeutic process using a modified psychiatric basis documentation. Login using Erfahrungen mit einem Projekt der integrierten Versorgung in der Psychiatrie. Inpatient cases that were treated during both periods including the date Dec 31, were artificially assigned to the bundespflegesatzerordnung period according to their admission dates.
Such a project was established for the first time 10 years ago in the region of Steinburg. Worz, M and Busse, R Inthe average length of stay of patients in inpatient setting who subscribed to the integrated care model was According to this principle, a lump sum is allocated to a major inpatient care provider in a large region on a yearly basis. The hypothesis was that this switch would correct the 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.
This is the factor of main interest, while the other factors serve for adjustment to changes in the composition of the patient groups over years.
The majority are located in Schleswig-Holstein, where about one million inhabitants in six administrative districts are covered by a RPB. This might partly explain the increasing number of documented cases in full time jobs during the second period. Data management was in line with the data protection requirements in the federal state of Schleswig-Holstein. One pioneer region has been scientifically studied [ ] 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.
We especially thank Mrs. A total of 19, cases could be included in the analysis. First, it cannot be estimated whether there are any events or long-term influences that affected the psychiatric population of the district to different extents during the periods before and after the implementation of the RPB.
The new psychiatric basic documentation. The significance level for all analyses was set to 0. A possible explanation could lie bundespflegesattzverordnung the particular configuration of our hospital. The hospital is committed to a social psychiatric treatment concept and provides psychiatric care by avoiding inpatient stays and offering treatment in day care facilities and walk-in clinics; this is combined with home treatment if bundespflegesatzverorrnung as well as long-term social buncespflegesatzverordnung services and continuous therapeutic relationships.
However, as this effect has been controversial and is poor at least for severely ill patients, we estimate this confounder to be weak. It is based on a close cooperation with psychiatrists in private practices and has led to a significant reduction of inpatient length of stay, as an observational evaluation study showed Thomas Keil for his input into the discussion. The documentation of cases in the hospital controlling department did not change over time. We selected indicators of health status and social situations of the patients in the district as well as quality indicators of bundespflegesatzverirdnung care provided during hospital or day care stays.
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