Schulz Holger, Koch Uwe
Abteilung für Medizinische Psychologie, Arbeitsgruppe Psychotherapie- und Versorgungsforschung, Universitätsklinikum Hamburg-Eppendorf, Germany.
Psychother Psychosom Med Psychol. 2002 May;52(5):244-7. doi: 10.1055/s-2002-28528.
In Germany health care services for patients with psychosomatic disorders are characterized by three specific features: A large amount of inpatient facilities, which have been developed outside psychiatric institutions and which are mainly rehabilitation clinics instead of acute clinics. We have tried to analyze whether (1) there is a sufficient number of inpatient facilities in Northern Germany, whether (2) the treatment of psychosomatic disorders should be conducted in large-scale outpatient clinics or in minor departments of community hospitals and (3) to what extent therapy should preferably be offered in acute rather than in rehabilitative settings. By means of different methodological approaches our analysis shows (1) a need for more facilities for the treatment of patients with psychosomatic disorders than legally established by the government, (2) the necessity to differentially allocate patients to appropriate clinics and (3) to encourage clinics to develop or to expand those therapeutic elements which aim more at rehabilitative or acute care.
在德国,针对身心疾病患者的医疗服务具有三个显著特点:大量的住院设施,这些设施是在精神病院之外发展起来的,主要是康复诊所而非急症诊所。我们试图分析:(1)德国北部是否有足够数量的住院设施;(2)身心疾病的治疗应该在大型门诊诊所还是社区医院的小科室进行;(3)治疗在多大程度上应优先在急症环境而非康复环境中提供。通过不同的方法,我们的分析表明:(1)需要比政府法定数量更多的身心疾病治疗设施;(2)有必要将患者区别分配到合适的诊所;(3)鼓励诊所发展或扩大那些更侧重于康复或急症护理的治疗要素。