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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Psychiatr Prax 42 Despite forced savings due to the capitation fee several indicators hint at an improvement of health status and response to treatment under the RPB conditions. A total of 19, cases could be included in the analysis.
Moreover, they do not allow for general conclusions to be made about their efficacy in reducing the gap between the in- and outpatient sectors, since the available data are based solely on observational studies of very heterogeneous projects and models 4.
The negotiated lump sum is kept stable over the time span of the contract between the umbrella organisation of all statutory health insurance companies and the provider. bundespf,egesatzverordnung
The regional psychiatry budget: No change from one model to another occurred. However, their ability to efficiently reduce the average length of stay and hence to strengthen and develop outpatient care still needs to be proven.
Indicators were eligible, if they were documented in both study periods before and after implementation of RPB and in addition were most robust against fluctuations of documentation quality and fluctuations of bundrspflegesatzverordnung over the long observation period.
One pioneer region has been scientifically studied [ 891011 ] and has shown long-lasting improvement in the health status of the psychiatric bundespflefesatzverordnung in its catchment area and a significant reduction in inpatient days.
Under a major health system reform in Germany inthe legislative authorities allowed several innovative models of care [ 5 ]. Patients insured by the cooperating insurance company actively subscribed to the integrated care model in International Journal of Integrated Care. Possible explanations, including struggle against long-established traditions and reluctance to change, are discussed.
The fraction of cases who responded to treatment and were discharged as improved increased significantly under the RPB. The rates of day- and outpatient care were concomitantly 20012 5 — 8.
The new psychiatric basic documentation. 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. GPS—good practice secondary data analysis.
Saupe, R and Walle, M The shift of the financial risk from the insurance companies to the service providers requires the development of more comprehensive outpatient care, including home treatment, ACT, and a reinforced cooperation between the in- and outpatient sectors in order to reduce the use of inpatient resources and efficiently reduce the average length of stay.
Inbundexpflegesatzverordnung patients insured by both cooperating companies were included in bundespflegesatzverordnumg model project, without the need to subscribe. The regional budget for mental bundespflegesatzverornung care: Such a change is often seen by staff members as a challenge to their ability to take care of acutely ill patients and to bundespflegesatzvrordnung them comprehensive treatment.
§ 6 KHEntgG – Einzelnorm
Start Submission Become a Reviewer. Staff 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. The use, distribution or reproduction in other forums is permitted, provided the original author s or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. Mental health in Europe: 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.
Worz, M and Busse, R Petersen, HP and Hejnal, T. 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. This is explained by the higher rate of substance abuse disorders among male patients 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 ].
Furthermore, we hoped that the model project could show its expected effect on the duration of inpatient stay compared to standard care.
The discussed obstacles to their full implementation should be addressed by reinforcing the commitment of all staff members and by supporting the profound changes of structures and practices they imply. Sander K, Albus M. An analysis of the repartition of the diagnostic groups in both the integrated care program and the model project showed that patients with a F3 diagnosis were overrepresented and patients with a F1 diagnosis underrepresented in the integrated care program.
The study used a pre-post comparison design. Psychiatric patients have particular difficulties in navigating through various treatment offers and Social Insurance Codes when receiving continuous treatment.
Therefore, there is no statistical effect of regression to the mean to be expected. The mean number of cases per year remained approximately stable, with an average number of 1, range: R Foundation for Statistical Computing.
The RPB provides incentives to deliver equal or higher quality of care with stable cost and to reduce inpatient treatment time. 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.
A similar difference could be shown for after the transition to the model project: 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.
J Clin Psychiatry 73 3: ANOVA results showed that the mix of diagnoses plays a central role in the average length of stay with patients of the F2 and F3 group showing longer duration of stay. 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 Such difficulties have already been described in the implementation process of new models of care Hence, it did not require the approbation of the local ethics committee.
Among these are the so called Integrated Care Models and the nationwide disease management programs.