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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 Bundespflegesatzerordnung RPB in the administrative District of Dithmarschen. This article has been cited by other articles in PMC. According to this principle, a lump sum is allocated to a major inpatient care provider in a large region on a yearly basis. Integrated care bundespflegesatzverordmung Germany-a stony but necessary road!
The study used a bundespflegesatzverordbung comparison design. Therefore, the data generated during the observation periods, before and after implementation of the RPB in particular, represented the clinical reality. How does Europe PMC derive its citations network? Psychiatric and psychotherapeutic inpatient care for the bundespflegedatzverordnungresidents of this predominantly rural district are provided by the only hospital that exists in the region. GPS—good practice secondary data analysis.
Strengths of the Study Methods First, the integrated treatment model was applied to all patients seeking inpatient treatment in the district. The regional budget for mental health care: The district of Dithmarschen began using the capitation principle only in Additionally, we did not analyse subgroups of various psychiatric diagnoses.
Health systems in transition. We used only categorical variables, which were documented using standard operation procedures by the staff, and which we expect to be more robust against any changes in the data management process.
One pioneer region has been scientifically studied [ 891011 ] and has shown bundespflegesatzverodrnung improvement in the health status of the psychiatric patients in its bundespflegesatzverlrdnung area and a significant reduction in inpatient days. Received May 12; Accepted Nov The RPB provides incentives to deliver equal or higher quality of care with stable cost and to reduce inpatient treatment time.
German Federal Employment Agency; Scientific evidence for integration of clinical psychiatry and community psychiatry. Only the most robust parameters were analysed in this study.
Additionally, the department tended to reduce documentation in general, as data verification by the medical review board of the statutory health bundespflegesatzverorrnung companies was stopped under RPB conditions. The regional psychiatry budget RPB: Mental health in Europe: Results A total of 19, cases could be included in the analysis.
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. 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.
During the repeated examination the documentation doctor made an error of 4. Busse R, Blumel M. Petersen HP, Hejnal T. 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 ].
Therefore, the RPB-model is well-suited to facilitating fundamental structural and procedural changes in psychiatric patient care. The distribution of first line diagnoses among these main categories remained stable between and Nevertheless a documentation with an error rate to such an extend is of no use for a base documentation, and this error rate must be taken into consideration in the interpretation of global medical statistics.
Therefore, there is no statistical effect of regression to the mean to be expected. 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 ].
All increasing expenditures such as salaries and overheads had bundespfldgesatzverordnung be compensated by reducing other expenditures such as inpatient treatment cost.
The corresponding errors of the house physicians for three digit numbers maximum were amounting to 8 p. The present study aims to evaluate selected aspects that represent a change in the psychiatric health status of patients in the Dithmarschen region who were included in the RPB.
Second, as the data were originally generated for bunrespflegesatzverordnung purposes, no special study setting, study staff or any special effect of testing procedures could come into effect.
Changes in mental health care by a regional budget: Therefore, it cannot be estimated whether individual diagnostic subgroups differ in their benefits from the RPB. 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 ].
This did not result in a worse outcome in terms of health status and social functioning in the population of severely psychiatric ill patients bundespflegrsatzverordnung the region. As a control group is missing, there are several limitations associated with the study design and data sources.