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 annual budget creates a strong financial incentive to reduce the use of inpatient care and develop more comprehensive offerings in the outpatient sector.

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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 introduction of a subscription-based integrated care model was supposed to lead to shorter average lengths of stay. 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 necessary as well as long-term social support services and continuous therapeutic relationships.

Psychiatr Prax 40 8: Additionally, the department tended to reduce documentation in general, as data verification by the medical review board of the statutory health insurance companies was stopped under RPB conditions.

International Journal of Integrated Care16 4 However, the results need to be replicated in other regions in Germany or in other health systems. 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. 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 RPB conditions the number of voluntary admissions increased significantly and the number of cases with suicidal ideas or behaviour before admission declined significantly. On the contrary, the average length of stay in this setting rose, against expectations, whereas they decreased as expected in day care setting.


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.

In day care setting, the average duration of stay of patients who subscribed to bundespflegesatzverordmung integrated care program in was The RPB enables healthcare providers to limit expenses. Psychiatr Prax 43 7: As we performed a pre-post comparison, there are several threats to the internal validity of 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 bundespflegesatzverordnujg subscribe to it.

The shift of vundespflegesatzverordnung care resources from the in- to the outpatient sector, and bundespflegesatzvetordnung reduction of average length of stay are crucial and have been addressed in many countries over the last years. All increasing expenditures such as salaries and overheads had to be compensated by reducing other expenditures such as inpatient treatment cost. The significance level for all analyses was set to 0.

This would bundespflegezatzverordnung in line with orientations wished by service providers, patients and their relatives. Bock T, Lambert M. 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 Budget RPB in the administrative District of Dithmarschen.

These results are shown in Table 4. These deficits have already been described in depth in previous studies and reports 12.

§ 6 KHEntgG – Einzelnorm

Personenzentrierte Krankenhausbehandlung Im Gemeindepsychiatrischen Verbund. In spite of these strong incentives, in the year following the introduction of the new model project the expected effect could only be marginally observed in our study. Male patients stayed on average 2. 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. This did not result in a worse outcome in terms of health status and social functioning in the population of severely psychiatric ill patients in the region.


Such a project was established for the first time 10 years ago in the region of Steinburg.

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. Limitations As a control group is missing, there are several limitations associated with the study design and data sources.

Erfahrungen mit einem Projekt der integrierten Versorgung in der Psychiatrie. Furthermore, we hoped that the model project could show its expected effect on the duration of inpatient stay compared to standard care. Possible explanations, including struggle against long-established traditions and reluctance to change, are discussed. Chance and opportunity to design psychiatric routine care individually and in the community.

The average lengths of stay in each diagnostic group after ICD in both inpatient and day care setting are summarized in Tables 2 and 3. Socio-demographic and clinical indicators of health status and social adjustment significantly improved. The ethical committee of the Medical Association of Schleswig-Holstein was informed about the study. Thus we expected to counter this effect after switching to the newly introduced subscription-free model project.

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. 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. We used only categorical variables, bundespflegesatzveroednung 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.