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. 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. The new psychiatric basic documentation.
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.
While during the period before the RPB all cases were treated as inpatients, between and 6, inpatient cases and 1, day care cases were documented.
Among these are the so called Integrated Care Models and the nationwide disease management programs. During hospital treatment, fewer restraining procedures were necessary and more cases could be regularly discharged, a higher percentage of those were improved compared to regular reimbursement conditions.
The documentation of cases in the hospital controlling department did not change over time. Results A total of 19, cases could be included in the analysis.
It has also been argued that the short-term reduction of admissions to the RPB would lead to a gradual worsening of the health status of the community in the long run.
In contrast to this, the results for the day care setting showed bundespflegesaztverordnung difference in the average lengths of stay between the integrated care program and the model project.
In this setting, ANOVA showed an effect of diagnosis on the length of stay in a similar way as in the inpatient setting.
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.
The analyses were repeated by a second researcher to ensure reliability. Suggest a Research Topic. There, the switch to the subscription-free model project led to a statistically significant shortening of the average length of stay when compared to the old integrated care program but not when compared to the standard care group.
Such difficulties have already been described in the implementation process of new models of care Psychiatr Prax 43 7: Statistical analysis was performed using SPSS International Journal of Integrated Care16 4p. Ulrike Stasun for her support in the data management process and Prof. Hence, the introduction of such a model should be seen as a long-term process involving profound changes in traditions and routines.
This is either because most of them need time to engage in a stable outpatient therapeutic relationship or because they are not actively given the opportunity to subscribe in the acute inpatient setting.
Staff members are often reluctant to engage in new models of care that imply bundrspflegesatzverordnung a profound change in the definition and practice of inpatient psychiatric care. However, this major change in the provision of care in the region became effective only during the last two years of the second study period.
The age at hospital admission was The length of stay of patients who did not take part in this program was On the contrary, the average length of stay in this setting rose, against expectations, whereas they decreased as expected in bundesplfegesatzverordnung care setting.
No influence of age could be shown. Sociodemographic and clinical indicators of health status and social adjustment of psychiatric cases at time of admission before and after implementation of the Regional Psychiatry Budget RPB in the administrative District of Dithmarschen. Psychiatric and psychotherapeutic inpatient care for the approximatelyresidents of this predominantly rural district are provided by the bundespflgeesatzverordnung hospital that exists in the region.
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.
In conclusion, model projects constitute a possible way of bridging in- and outpatient care for all patient categories, particularly the most severely ill. In Munich, the average length of stay decreased since the implementation of the new integrated care model and patients reported a high level of satisfaction, although the implementation process was not free of difficulties 9.
In return the provider is free to offer all forms of treatment and to construct individual models of integrated care within the RPB that specifically suit the region and the needs of community members.
Worz, M and Busse, R This would be in line with orientations wished by service providers, patients and their relatives. This article is part of the Research Topic New models of care for patients with severe mental illness — bridging in- and outpatients.
The RPB provides incentives to deliver equal or higher quality of care with stable cost and to reduce inpatient treatment time.
§ 6 KHEntgG – Einzelnorm
Under a major health system reform in Bundespflegesatzverorvnung inthe legislative authorities allowed several innovative models of care [ 5 ]. Indicators were eligible, if they were bundspflegesatzverordnung in both study periods before and after implementation of RPB and in addition were most robust against fluctuations of documentation quality and fluctuations of staff over the long observation period.
ANOVA results for the inpatient setting showed age did not affect the average length of stay. 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 ].
New models of care aimed at reinforcing the outpatient sector have been introduced in Germany over the last few years. Indicators were — Legal form of admission to hospital as indicator of severity of illness — Suicidality at time of admission as indicator of severity 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.
The newly introduced model projects could represent a great opportunity to deal with this issue. 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. We especially thank Mrs. Inpatient treatment devolves into intensive crisis management, often leaving symptoms remission and recovery to the outpatient sector.
International Journal of Integrated Care.