[Nonnative guidelines for allocating human resources in child and adolescent psychiatry using average values under convergence conditions instead of price determination - analysis of the data of university hospitals in Germany concerning the costs of calculating day and minute values according to Psych-PV and PEPP-System]. / Normative Vorgaben zum Personaleinsatz in der Kinder- und Jugendpsychiatrie statt Preisfindung anhand von Mittelwerten unter Konvergenzbedingungen.

OBJECTIVE: Despite substantial opposition in the practical field, based on an amendment to the Hospital Financing Act (KHG). the so-called PEPP-System was introduced in child and adolescent psychiatry as a new calculation model. The 2-year moratorium, combined with the rescheduling of the repeal of the psychiatry personnel regulation (Psych-PV) and a convergence phase, provided the German Federal Ministry of Health with additional time to enter a structured dialogue with professional associations. Especially the perspective concerning the regulatory framework is presently unclear. METHOD: In light of this debate, this article provides calculations to illustrate the transformation of the previous personnel regulation into the PEPP-System by means of the data of §21 KHEntgG stemming from the 22 university hospitals of child and adolescent psychiatry and psychotherapy in Germany. In 2013 there was a total of 7,712 cases and 263,694 calculation days. In order to identify a necessary basic reimbursement value th1\t would guarantee a constant quality of patient care, the authors utilize outcomes, cost structures, calculation days, and minute values for individual professional groups according to both systems (Psych-PV and PEPP) based on data from 2013 and the InEK' s analysis of the calculation datasets. CONCLUSIONS: The authors propose a normative agreement on the basic reimbursement value between 270 and 285 EUR. This takes into account the concentration phenomenon and the expansion of services that has occurred since the introduction of the Psych-PV system. Such a normative agreement on structural quality could provide a verifiable framework for the allocation of human resources corresponding to the previous regulations of Psych-PV.

[Aesthetic/Plastic Surgery in Children as Seen from the Perspective of Child and Adolescent Psychiatry and Psychotherapy]. / Ästhetisch-plastische Operationen bei Kindern-Sicht der Kinder- und Jugendpsychiatrie und -psychotherapie.

Physical deformities may cause psychological stress and lead to psychological disorders in children and adolescents. On the other hand, the correction of non-pathological conditions is a legal issue in patients unable to consent, a group that is partly made up of minors. This article provides an overview on available evidence on the psychological consequences of physical deformities, psychiatric contraindications for plastic surgery due to psychological disorders, and on the issue of minors' ability to consent.

[Statement by the Commission on Youth Welfare Services of the Child and Adolescent Professional Societies on Integration Assistance according to Section Paragraph 35a SGB VIII]. / Stellungnahme zur Eingliederungshilfe nach S35a SGB VIII der Kommission Jugendhilfe der kinder- und jugendpsychiatrischen Fachgesellschaften.

Paragraph 35a SGB VIII of the German Social Code (assistance for minors with mental illness) in practise creates difficulties for child and adolescent psychiatrists. Uncertainty prevails with regard to the role of the child and adolescent psychiatrist in the course of the proceedings, as well as about his/her duties and rights, and how to structure collaboration with the youth services and the parents. The Commission for the Youth Welfare Services of the German societies of child and adolescent psychiatry has generated guidelines for the proceedings according to paragraph 35a SGB VIII in order to resolve recurrent questions. The statement by the commission indicates solutions to these questions. A form was prepared to help child and adolescent psychiatrists to fulfil the necessary requirements for the proceedings.

[Legal binding character of guidelines]. / Zur rechtlichen Verbindlichkeit von Leitlinien.

Guidelines as recommendations by the medical associations concerning the diagnosis and treatment of certain diseases do not have the character of judicial norms. However, they may have an impact on decision-making in court. Within social security insurance law, and especially in medical malpractice litigation, the medical standard has become a legal term. As far as statements in guidelines render the actual standard as affirmed, the more binding is their character with respect to judicial questions. This article deals with this interplay between medical quality assurance and the legal demands on medical action. As a basis for discussion of this issue the relevant jurisdiction will be represented. Its impact on the guidelines for child and adolescent psychiatry will be pointed out as a concrete example.