Kappauf Herbert, Von Rad Michael, Galuska Joachim, Irle Hanno, Kindt Heinz, Nosper Manfred, Kapfhammer Hans-Peter, Wolfersdorf Manfred, Zaudig Michael
Herbert Kappauf, Medizinische Klinik 5, Klinikum Nürnberg, Germany.
Psychother Psychosom Med Psychol. 2002 May;52(5):248-52. doi: 10.1055/s-2002-28527.
Estimations of the requirement for acute in-patient care of patients with psychosomatic diseases in Bavaria have to rely on respective data on their incidence and prevalence as valid requirement data are missing. The required capacity of in-patient beds depends on several, inconsistently figured parameters: hospitalization rate, length of stay, occupancy rate. Based on conservative assumptions the hospitalization rate was calculated to be at least 1.3 admissions per 1000 and for adequate treatment the average length of stay should not be limited to less than 50 days. In order to avoid unnecessary delay of treatment a realistic occupancy rate has to be 90 %. Thus the minimal capacity for in-patient care is assessed to be 2453 beds. At present patients with psychosomatic diseases in Bavaria receive in-patient treatment in psychosomatic departments of general hospitals, hospitals and rehab clinics of psychosomatic and psychotherapeutic medicine, and in hospitals of psychiatry and psychotherapy, in each with a different focus. When the expertise was drafted these acute care and rehab hospitals provided some 2500 beds - with only 76 beds in general hospitals. For quality assessment of the available beds for in-patient care and future planning minimal standards of structural quality have to be consented. At present it is not possible to make a clear and substantial distinction between the treatment for patients with psychosomatic diseases in acute-care hospitals and in psychosomatic rehab clinics respectively. Thus, the necessary in-patient rehab capacity can only be assessed roughly. The existing pluralism of the in-patient care providing system for patients with psychosomatic diseases is considered to be appropriate for different needs of this patient group. In the future excellent care for this patient group will acknowledge options for a more flexible and interconnected care-providing system. This is a publication of the complete expertise by the project group "Acute In-patient Care for Patients with Psychosomatic Diseases in Bavaria" which has been handed to the Bavarian Ministry of Social Affairs in December 1999.
由于缺少有效的需求数据,估算巴伐利亚州心身疾病患者急性住院护理需求只能依据其发病率和患病率的相关数据。住院床位所需容量取决于几个计算方式不一致的参数:住院率、住院时长、床位占用率。基于保守假设,计算得出住院率至少为每1000人中有1.3例入院,为进行充分治疗,平均住院时长不应少于50天。为避免不必要的治疗延误,实际床位占用率应为90%。因此,评估得出住院护理的最小容量为2453张床位。目前,巴伐利亚州的心身疾病患者在综合医院的心身科、心身与心理治疗医学的医院及康复诊所、以及精神病学与心理治疗医院接受住院治疗,各机构的重点有所不同。在起草这份专业报告时,这些急性护理和康复医院共提供了约2500张床位,其中综合医院仅有76张。为评估现有住院护理床位的质量并进行未来规划,必须商定结构质量的最低标准。目前,无法明确且实质性地区分急性护理医院和心身康复诊所中心身疾病患者的治疗情况。因此,只能大致评估所需的住院康复容量。心身疾病患者住院护理提供系统现有的多元化被认为适合该患者群体的不同需求。未来,为该患者群体提供优质护理将认可建立一个更灵活且相互关联的护理提供系统的选择。这是“巴伐利亚州心身疾病患者急性住院护理”项目组完整专业报告的出版物,已于1999年12月提交给巴伐利亚州社会事务部。