[Implementing models of cross-sectoral mental health care (integrated health care, regional psychiatry budget) in Germany: systematic literature review]. / Systematische Literaturübersicht zur Implementierung der sektorübergreifenden Versorgung (Regionalbudget, integrierte Versorgung) in Deutschland.

OBJECTIVE: Cross-sectoral integrated health-care and the regional psychiatry budget are two models of cross-sectoral health care (comprising in-patient and out-patient care) in Germany. Both models of financing were created in order to overcome the so-called fragmentation in German health care. The regional psychiatry budget is a specific solution for psychiatric services whereas integrated health care models can be developed for all areas of health care. The purpose of this overview is to elucidate both the current state of implementation of these models and the results of evaluation research. METHODS: Systematic literature review, additional manual search. RESULTS: 28 journal articles and 38 websites referring to 21 projects were identified. The projects are highly heterogenuous in terms of size, included populations and services, aims, and steering-function (concerning the different pathways of care). CONCLUSIONS: The projects yield innovative models of mental health care capable of competing with the co-existing traditional financing systems of in-patient and out-patient services. The future of mental health care organisation in Germany is currently open and under political discussion.

[PGI-I (patient's global impression) as an outcome and quality indicator of psychiatric in-patient treatment: results and concordance with doctor's assessments]. / PGI-I (Patient's Global Impression) als Outcome und Qualitätsindikator bei stationärer Behandlung: Ergebnisse und Übereinstimmung mit Beurteilungen der Behandler.

OBJECTIVE: To examine the Patient Global Impression Scale of Improvement (PGI) as a quality indicator in routine psychiatric in-patient treatment and to determine its concordance with doctors' assessments. METHODS: Patients treated in 2007 in 5 hospitals and 4 day-clinics were included. A set of patient and treatment characteristics (German BADO) and CGI scales were recorded in all patients. Patients were required to give a PGI rating at discharge. RESULTS: PGI ratings could be obtained in 70.3 of the patients (N = 3957). PGI and doctors' CGI-I ratings were in agreement with no more than one degree of difference on the 7-point scale of the PGI in 89.8 %. Characteristics of those patients who significantly deviated from the doctors' assessments were determined. CONCLUSIONS: The PGI scale is appropriate as a quality indicator for routine clinical treatment which can rather easily be obtained.