Huss M, Jenetzky E, Lehmkuhl U
Klinik für Psychiatrie, Psychosomatik und Psychotherapie der Kindes- und Jugendalters, Charité Campus Virchow-Klinikum der Humboldt-Universität zu Berlin, Augustenburger Platz 1, 13353 Berlin.
Prax Kinderpsychol Kinderpsychiatr. 2001 Jan;50(1):31-44.
Day treatment plays an increasingly important role in German child and adolescent psychiatry. In spite of a steady and ongoing increase of day treatment facilities over the past 15 years only few empicial data on the structure of German day treatment are available. The study refers to an Germany wide assessment of all day treatment centers (DTC). 45 out of 61 DTC responded (reply rate 74%). Analyses were done over 560 treatment places used by 69% male and 31% female patients mean ages 10 years and 2 months. Mean treatment duration is 104 days without differences with respect to the primary psychotherapeutic orientation (behavioral, psychodynamic, family therapy, other). Personnel is in 80.5% of the DTC below the governmental guidelines. Rates per day vary between 280 DM and 617 DM with a mean of 389 DM. Mean treatment costs per patient are 36.303 DM (min.: 12.825 DM; max.: 89.793 DM). Rates per day and duration of treatment are negatively correlated: The higher the rate per day, the shorter the treatment (explained variance: 17%). This correlation can only be explained indirectly by more personnel as associated with higher daily rates. However, more influential is the amount of time the children are present in day treatment per week: The longer the children are present, the shorter the duration of the whole treatment. Diagnosis, gender, and age only influence duration and costs of the treatment marginally. Network-effects as operationalized by the availability of additional inpatient and outpatient facilities did not influence costs and duration of day treatment.
日间治疗在德国儿童和青少年精神病学中发挥着越来越重要的作用。尽管在过去15年里日间治疗设施持续稳步增加，但关于德国日间治疗结构的实证数据却很少。该研究涉及对德国所有日间治疗中心（DTC）的一项全国性评估。61个DTC中有45个做出了回应（回复率74%）。分析是针对560个治疗场所进行的，使用这些场所的患者中69%为男性，31%为女性，平均年龄为10岁零2个月。平均治疗时长为104天，在主要心理治疗取向（行为治疗、心理动力学治疗、家庭治疗、其他）方面没有差异。80.5%的DTC的人员配备低于政府指导方针。每日费用在280德国马克至617德国马克之间，平均为389德国马克。每位患者的平均治疗费用为36303德国马克（最低：12825德国马克；最高：89793德国马克）。每日费用与治疗时长呈负相关：每日费用越高，治疗时间越短（解释方差：17%）。这种相关性只能通过与较高每日费用相关的更多人员来间接解释。然而，更具影响力的是儿童每周在日间治疗中的时长：儿童在日间治疗的时间越长，整个治疗的时长就越短。诊断、性别和年龄对治疗时长和费用的影响微乎其微。由额外的住院和门诊设施可用性所衡量的网络效应并未影响日间治疗的费用和时长。
