Universität zu Köln

von Peter, Sebastian, Ignatyev, Yuriy, Johne, Jakob, Indefrey, Sonja, Kankaya, Onur Alp, Rehr, Burkhard, Zeipert, Manfred, Bechdolf, Andreas, Birkner, Thomas, Deister, Arno, Duve, Annette, Rout, Sandeep, Scherk, Harald, Schulz-Dubois, Anna, Wilms, Bettina, Zedlick, Dyrk, Grollich, Peter, Braun, Bernard, Timm, Jurgen and Heinze, Martin (2019). Evaluation of Flexible and Integrative Psychiatric Treatment Models in Germany - A Mixed-Method Patient and Staff-Oriented Exploratory Study. Front. Psychiatry, 9. LAUSANNE: FRONTIERS MEDIA SA. ISSN 1664-0640

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Abstract

Contrary to the practice in some countries, access to flexible and integrated forms of psychiatric care (FIT models) is limited in Germany. Several legislations have been introduced to improve this situation, notably the recent 64b (flexible and integrative treatment model; FIT64b) of the German Social Code, which allows for a capitation-based accounting of fees for services. The aim of this study was to explore the effects of FIT64b implementation on various stakeholders (patients, informal caregivers and staff) in 12 psychiatric hospital departments across Germany. Structural as well as quantitative and qualitative data are included, with integration of different methodological approaches. In all departments, the implementation of the new accounting system resulted into a relatively stable set of structural and processual changes where rigid forms of mainly inpatient care shifted to more flexible and integrated types of outpatient and outreach treatments. These changes were more likely to be perceived by patients and staff, and likewise received better evaluations, in those departments showing higher level or longer duration of implementation. Patients' evaluations, furthermore, were largely influenced by the advent of continuous forms of care, better accessibility, and by their degree of autonomy in steering of their services.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code von Peter, Sebastian UNSPECIFIED UNSPECIFIED UNSPECIFIED Ignatyev, Yuriy UNSPECIFIED UNSPECIFIED UNSPECIFIED Johne, Jakob UNSPECIFIED UNSPECIFIED UNSPECIFIED Indefrey, Sonja UNSPECIFIED UNSPECIFIED UNSPECIFIED Kankaya, Onur Alp UNSPECIFIED UNSPECIFIED UNSPECIFIED Rehr, Burkhard UNSPECIFIED UNSPECIFIED UNSPECIFIED Zeipert, Manfred UNSPECIFIED UNSPECIFIED UNSPECIFIED Bechdolf, Andreas UNSPECIFIED UNSPECIFIED UNSPECIFIED Birkner, Thomas UNSPECIFIED UNSPECIFIED UNSPECIFIED Deister, Arno UNSPECIFIED UNSPECIFIED UNSPECIFIED Duve, Annette UNSPECIFIED UNSPECIFIED UNSPECIFIED Rout, Sandeep UNSPECIFIED UNSPECIFIED UNSPECIFIED Scherk, Harald UNSPECIFIED UNSPECIFIED UNSPECIFIED Schulz-Dubois, Anna UNSPECIFIED UNSPECIFIED UNSPECIFIED Wilms, Bettina UNSPECIFIED UNSPECIFIED UNSPECIFIED Zedlick, Dyrk UNSPECIFIED UNSPECIFIED UNSPECIFIED Grollich, Peter UNSPECIFIED UNSPECIFIED UNSPECIFIED Braun, Bernard UNSPECIFIED UNSPECIFIED UNSPECIFIED Timm, Jurgen UNSPECIFIED UNSPECIFIED UNSPECIFIED Heinze, Martin UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-159000
DOI:	10.3389/fpsyt.2018.00785
Journal or Publication Title:	Front. Psychiatry
Volume:	9
Date:	2019
Publisher:	FRONTIERS MEDIA SA
Place of Publication:	LAUSANNE
ISSN:	1664-0640
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language MENTAL-HEALTH-CARE; ASSERTIVE COMMUNITY TREATMENT; CRISIS RESOLUTION TEAMS; REGIONAL BUDGET; SERVICES; PEOPLE; CONTINUITY; ILLNESS; IMPLEMENTATION; COMPONENTS Multiple languages Psychiatry Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/15900