Bramesfeld Anke, Wismar Matthias
Abteilung Epidemiologie, Sozialmedizin und Gesundheitssystemforschung, Medizinische Hochschule Hannover, Germany.
Psychiatr Prax. 2003 Sep;30(6):318-25. doi: 10.1055/s-2003-42165.
Coordination of all psychiatric services is essential for the successful implementation of community oriented services, particularly in a decentralised health system like the one in Germany. This study investigates which mechanisms are implemented for coordinating and planning psychiatric services throughout the 16 German States (Länder).
Analysing mental health legislation and policy documents of the States. Guided expert interviews with the psychiatry departments of the State governments.
Coordinating and planning panels exist in all States on district level and in most States on State level for various tasks. Most of these mechanisms are implemented without legal obligation. 4 States have a mental health evaluation panel, which scrutinises all psychiatric services once a year and reports publicly to the government. 12 States have a mental health legislation and 13 States published a central psychiatric planning document.
The continous implementation of mechanisms for coordinating and planning psychiatric services in the German States represent the dynamics of psychiatric reforms there. The effect of these mechanisms on the implementation of community oriented psychiatric care should be subject to further research.
对于以社区为导向的服务的成功实施而言，所有精神科服务的协调至关重要，尤其是在像德国这样的分散式卫生系统中。本研究调查了在德国16个州（联邦州）中为协调和规划精神科服务而实施的机制。
分析各州的精神卫生立法和政策文件。对州政府的精神科部门进行专家访谈。
所有州在地区层面以及大多数州在州层面都设有用于各种任务的协调和规划小组。这些机制大多是在没有法律义务的情况下实施的。4个州设有精神卫生评估小组，该小组每年对所有精神科服务进行审查，并向政府公开报告。12个州有精神卫生立法，13个州发布了中央精神科规划文件。
德国各州持续实施精神科服务协调和规划机制体现了该国精神科改革的动态情况。这些机制对以社区为导向的精神科护理实施的影响应进一步研究。
