Hospital length of stay among older people treated with flexible and integrative psychiatric service models in Germany.
Int J Geriatr Psychiatry
; 34(11): 1557-1564, 2019 11.
Article
em En
| MEDLINE
| ID: mdl-31276239
ABSTRACT
OBJECTIVE:
Since 2012, a new law (§64b, Book V of the Social Security Code [SGB V]) regulates the implementation of flexible and integrative psychiatric treatment projects (FIT64b) in Germany. FIT64b allows rapid discharge of patients from inpatient to outpatient settings and cost reductions of hospital stays. Several psychiatric centres exclusively provide FIT64b; others provide FIT64b alongside with standard health care. The aim of the study was to assess the average hospital length of stay (AHLS) of older patients with mental illness included in FIT64b projects.METHODS:
A secondary data analysis was conducted using administrative data from eight German mental health centres providing FIT64b. The effects of gender, age, type of centre, and main diagnosis on AHLS were calculated for all older patients with age 65 years or older (n = 3495) treated in FIT64b in the year 2016. Data were analysed with descriptive statistics and robust multiway procedures.RESULTS:
The AHLS of older people with mental illness was 4.8 (SD = 11.5) days. The AHLS was shorter in centres exclusively providing FIT64b than in centres providing FIT64b alongside with standard health care 3.2 (SD = 6.4) vs 8.4 (SD = 17.8) days, P = .001. This difference was particularly marked among patients with schizophrenia spectrum disorders, mood disorders, and neurotic, stress-related, and somatoform disorders.CONCLUSIONS:
FIT64b relates to very short AHLS even among older people. Centres using FIT64b alongside with standard health care usually provide standard care to most patients, which could lead to lower fidelity in the implementation of FIT64b.Palavras-chave
Texto completo:
1
Temas:
ECOS
/
Estado_mercado_regulacao
Bases de dados:
MEDLINE
Assunto principal:
Tempo de Internação
/
Transtornos Mentais
Tipo de estudo:
Diagnostic_studies
Limite:
Aged
/
Aged80
/
Female
/
Humans
/
Male
País/Região como assunto:
Europa
Idioma:
En
Revista:
Int J Geriatr Psychiatry
Assunto da revista:
GERIATRIA
/
PSIQUIATRIA
Ano de publicação:
2019
Tipo de documento:
Article
País de afiliação:
Alemanha