[区域精神病学预算：精神科护理新的多部门融资模式的成本与效果]
[The regional psychiatry budget: costs and effects of a new multisector financing model for psychiatric care].
作者信息
Roick Christiane, Heinrich Sven, Deister Arno, Zeichner Dirk, Birker Thomas, Heider Dirk, Schomerus Georg, Angermeyer Matthias C, König Hans-Helmut
机构信息
Universität Leipzig, Professur für Gesundheitsökonomie, Klinik für Psychiatrie, Berlin.
出版信息
Psychiatr Prax. 2008 Sep;35(6):279-85. doi: 10.1055/s-2008-1067432. Epub 2008 Sep 4.
OBJECTIVE
To evaluate a new multi-sector financing model for psychiatric care based on the capitation principle (Regional Psychiatry Budget, RPB).
METHODS
Patients with a diagnosis according to ICD-10 F10, F2, and F3 were interviewed in the model region (MR, N=258) and a control region (CR, N=244) financed according to the fee-for-service principle. Effectiveness of care was assessed before RPB-introduction and after 1.5 years. Use of care was determined semi-annually.
RESULTS
Costs of inpatient psychiatric treatment decreased more strongly in the MR, while hospital based outpatient care and day clinic treatment were intensified in comparison to the CR. Quality of life, severity of illness and illness-specific symptoms in patients improved similarly in MR and CR. The functional level improved more in the MR than in the CR, which was especially evident in schizophrenia patients.
CONCLUSIONS
Inpatient psychiatric care costs can be reduced with the RPB without compromising the quality of care.
目的
基于按人头付费原则（区域精神病学预算，RPB）评估一种新的精神科护理多部门融资模式。
方法
在按照按服务收费原则融资的模型区域（MR，N = 258）和对照区域（CR，N = 244）对根据国际疾病分类第10版F10、F2和F3诊断的患者进行访谈。在引入RPB之前和1.5年后评估护理效果。每半年确定一次护理使用情况。
结果
与对照区域相比，模型区域住院精神科治疗费用下降更为明显，而以医院为基础的门诊护理和日间诊所治疗有所加强。模型区域和对照区域患者的生活质量、疾病严重程度和特定疾病症状改善情况相似。模型区域患者的功能水平改善程度高于对照区域，这在精神分裂症患者中尤为明显。
结论
使用RPB可以降低住院精神科护理费用，而不影响护理质量。
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