[Intensive outpatient treatment - a therapy option for all patients in child and adolescent psychiatry or just for a few?] / Kinder- und jugendpsychiatrische stationsäquivalente Behandlung (StäB): Therapieoption ­ für alle oder für wenige?

Intensive outpatient treatment - a therapy option for all patients in child and adolescent psychiatry or just for a few? Abstract. Objective: "Child and adolescent psychiatric ward-equivalent treatment" (= stationsäquivalente Behandlung, StäB) is an intensive daily home treatment that has now become available in Germany. Conditions for StäB services were negotiated were negotiated, authorized and came into force by German healthcare commissioners and hospitals on 1 January 2018. However, to date few hospitals in Germany offer StäB, and its feasibility has been questioned. This study evaluates the first 58 cases of StäB in the Department of Child and Adolescent Psychiatry, ZfP Südwürttemberg (2018-2019). Method: All patients admitted consecutively to StäB from 1 January 2018 to 15 August 2019 were included and evaluated solely using descriptive analyses in SPSS.25. Results: The average length of stay in StäB was 37.95 days (SD 15.35). 86.2 % of the families completed treatment, with 3 patients discontinuing treatment and 5 patients needing inpatient admission. Unlike in the literature, internalising disorders predominated (70.7 %), whereas externalizing disorders were diagnosed in only 27.8 % of the patients. The cost of treatment in StäB was on average 8779.25 €. Conclusions: StäB is a viable and well-accepted new treatment alternative for patients requiring inpatient admission. The multiprofessionality of treatment as well as daily contacts are required. Feasibility under the conditions set is given. The average length of stay is slightly longer, but the costs are lower than those of inpatient treatment.

[Evaluation of a Model of Cross-Sectorial Mental Health Care (Integrated Health): Service Use and Treatment Quality]. / Evaluation eines Modells zur sektorübergreifenden Integrierten Versorgung mittels Leistungsnutzung, Zufriedenheit und Symptomlast.

OBJECTIVE: To evaluate a model of Integrated Care (IC) at the Centres for Psychiatry Suedwuerttemberg for all kinds of mental disorders implemented in 2010. METHODS: We used two different approaches. Patients who subscribed to the IC model (N = 98) were compared to a control group (N = 77) 1. in a prospective design with regard to treatment satisfaction (ZUF-8) and symptom burden (BSI) and 2. in a panel design regarding use of in-patient and out-patient services in the year before and after inscription. RESULTS: Patients who subscribed to the IC model had used more services in the year before subscription compared to those who declined. Compared to the control group, IC patients had a greater increase of use of out-patient services, use of in-patient services (hospital days) was lower after one year. Treatment satisfaction and symptom burden did not differ significantly between groups. CONCLUSIONS: Under the conditions of IC treatment is realized increasingly outside the hospital without loss of quality.

[Analysis of patterns of in-patient and out-patient mental health care by use of routine data]. / Sektorübergreifende Analyse psychiatrischer Behandlungs- und Versorgungsleistungen mittels Routinedaten.

OBJECTIVE: The Centre of Psychiatry Suedwuerttemberg routinely records data on service use of in-patient units, day hospitals and out-patient services on a daily basis as well as data on the respective patients according to the German Basic Documentation (BADO). Other psychiatric services in the catchment area of the districts Ravensburg and Bodenseekreis such as services of sheltered living, residential homes and vocational services collect identical data per day of use. Aim of the study is to compare routinely recorded data of mental health service use and direct cost of service use with sample data. We compared analyses of mental health service use and direct cost of service use with routinely recorded data with analyses using sample data. METHODS: Concerning the year 2008, we joined these different data sets, processing them in order to obtain pseudonymity and fulfil data protection requirements. This joint data set maps the total expenditures for psychiatric care utilisation in this region. RESULTS: Using a data set of this kind, analyses of health economy are possible which are comparable or even superior to those from sample data. CONCLUSION: Routinely recorded data are a cost-saving alternative to sample data.