Roick Christiane, Deister Arno, Zeichner Dirk, Birker Thomas, König Hans-Helmut, Angermeyer Matthias C
Universität Leipzig, Klinik und Poliklinik für Psychiatrie.
Psychiatr Prax. 2005 May;32(4):177-84. doi: 10.1055/s-2004-834736.
Due to increasing health care expenditures the discussion about advantages and disadvantages of new methods for resource allocation in mental health care has been intensified. A promising model is the Regional Budget for Mental Health Care, which is currently being examined in Schleswig-Holstein. The present paper describes first experiences with the new resource allocation model. BASIC CONDITIONS: An annual budget, provided for the treatment of a fixed number of patients, makes it possible to reduce inpatient capacity in favour of improved community-integrated approaches for the treatment of acute psychiatric illness.
In a first step inpatient capacity will be reduced by 8 percent. By the end of 2007 capacity for hospital day care shall be increased by 87 percent and a home treatment will be implemented. The previous working method, orientated to treatment setting, will be replaced by an approach specialized in diagnostic groups.
The Regional Budget could improve the continuity and flexibility of patient care. Service providers become motivated to treat in a way, which with little resource consumption achieves a long lasting health status improvement. For health insurances the Regional Budget is an opportunity to limit cost increases.
由于医疗保健支出不断增加,关于精神卫生保健资源分配新方法优缺点的讨论日益激烈。一个有前景的模式是精神卫生保健区域预算,目前石勒苏益格-荷尔斯泰因州正在对其进行研究。本文介绍了这种新资源分配模式的初步经验。
为治疗固定数量患者提供的年度预算,使得有可能减少住院治疗能力,转而支持采用改进的社区综合方法治疗急性精神疾病。
第一步,住院治疗能力将降低8%。到2007年底,日间医院护理能力将提高87%,并将实施家庭治疗。以前以治疗环境为导向的工作方法将被专门针对诊断组的方法所取代。
区域预算可以提高患者护理的连续性和灵活性。服务提供者有动力以一种资源消耗少但能长期改善健康状况的方式进行治疗。对于健康保险来说,区域预算是限制成本增加的一个契机。