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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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This has affected the study region [ 20 ], which could help psychiatric patients to return to the employment market, as psychiatric patients are well-known to be the first group to be socially disadvantaged when the labour market is under pressure [ 21 ]. No use, bundespflegesatzverordnhng or reproduction is permitted which does not comply with these terms. Such a change is often seen by staff members as a challenge to their bundespflegestazverordnung to take care of acutely ill patients and to offer them comprehensive treatment.

The introduction of a subscription-based integrated care model was supposed to lead to shorter bundespflegesazverordnung lengths of stay. Bock T, Lambert M. 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 influence of age could be shown.

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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.

Hence, it did not require the approbation of the local ethics committee. After 5 years, the accompanying research of the University of Leipzig showed that the use of inpatient resources within the regional budget in Steinburg was considerably reduced.

This is explained by the higher rate of substance abuse disorders among male patients No statistically significant difference regarding diagnostic groups could be shown between and for patients in the integrated care and model project in both inpatient and day care setting. Psychiatr Forsch S1: Mit Und Ohne Bett. 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 average length of stay for all these groups were calculated and compared.

§ 6 KHEntgG – Einzelnorm

These results are shown in Table 5. Under RPB conditions the number of voluntary admissions increased significantly and the number of cases with suicidal ideas or behaviour before admission declined significantly.


Inall patients insured by both cooperating companies were included in the model project, without the need to subscribe. Indeed, the hospital began to cooperate with the public medical service that is responsible for initiating compulsory admissions in cases of severe acute mental illness. We especially thank Mrs.

Such data would however be of great interest and should be taken into consideration in further studies aimed at evaluating the implementation of new models of care and their effect on the average duration of stay. MH contributed to the conception of the article, discussion of the results, and manuscript redaction and supervised the whole process. 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.

Berghoefer has done research in long-term evaluation and prophylaxis of affective disorders, treatment algorithms in therapy-resistant affective disorders, and long-term lithium therapy. Under this model, the provider is free to offer all forms of treatment and to construct individual models of integrated care that specifically suit the region and the needs of community members.

Psychiatr Prax 40 Sociodemographic and treatment-related categorical variables were averaged over the years without and with the RPB; then chi 2 -Tests were performed with the null hypothesis that the distribution of the categories of variables was the same in both periods.

Model projects require the full commitment of all staff members in managing the limited financial resources allowed by the insurance company and allocating them preferentially to the outpatient sector. One of the most important limitations of the present study is the lack of outpatient data. Inthe average length of stay of patients in inpatient setting who subscribed to the integrated care model was The significance level for all analyses was set to 0.

Bundespfelgesatzverordnung were — Legal form of admission to hospital as indicator of severity of illness — Suicidality at time of admission as indicator of bundesplfegesatzverordnung of illness — Working situation before admission as indicator of social functioning and autonomy — Housing situation before admission as indicator of social functioning and autonomy — Duration of inpatient treatment — Legal form of discharge after hospital or day care treatment — Number of cases for whom restraining procedures were necessary during inpatient stay — Global estimation of treatment response at time of discharge, based on the most recent psychiatric assessment by the treating physician and documented in the standardized documentation system.


Psychiatrische Pflege 16 1: For example, the employment situation in Germany has generally improved during the last decade [ 19 ]. These results are shown in Table 4. The model has been described in detail elsewhere [ 791012 ].

Published on 31 Dec Administrative, anonymised data for analysis were contributed a by the hospital controlling department, which provided the number of cases admitted to inpatient or day care treatment per year, starting in ; and b by the psychiatric department, which provided the number of forced admissions, the number of restraining procedures during inpatient stays which must be vundespflegesatzverordnung in Germanyand the clinical parameters that were documented in a standardised basic psychiatric documentation system BADO for the admission and discharge of each case [ 1314 ].

The study question was set up only during a secondary data analysis. Under a major health system reform in Germany inthe legislative authorities allowed several innovative models of care [ 5 ].

In Krefeld, a new home treatment-based implemented model proved to be effective in increasing the satisfaction of patients and their next of kin, while preserving a constant quality of care when compared to standard inpatient care 13 All patients insured by the contracting insurance company benefit from the program without active subscription, thus allowing the most severely ill patients to be part of such a program.

The number of cases living in their own home increased and the number of cases in sheltered housing situations decreased significantly Table 1. Patients insured by the cooperating insurance company actively subscribed to the integrated care model in Analysing the impact of health-care system change in the EU member states—Germany.

Saupe, R and Walle, M A total of 19, cases could be included in the analysis. A potential problem of the integrated care model is that patients must actively subscribe to it, with the risk that many severely ill patients, who should primarily benefit from such a program, do not get to subscribe to it. Publications Office of the European Union, p. In this model, a global annual budget is allocated to hospitals by the insurance companies to finance psychiatric care.

Erfahrungen mit einem Projekt der integrierten Versorgung in der Psychiatrie. But besides those elements, the absence of a relevant reduction in the average length of stay raises concerns about the ability of model projects and other similar initiatives to change long-established care traditions.