Kowitz S, Zielasek J, Gaebel W
Klinik und Poliklinik für Psychiatrie und Psychotherapie, LVR-Klinikum Düsseldorf, Heinrich-Heine-Universität, Medizinische Fakultät, Düsseldorf.
Dtsch Med Wochenschr. 2014 Jun;139(23):1249-52. doi: 10.1055/s-0034-1370039. Epub 2014 May 27.
For several years, there has been a significant increase of the utilization of health care due to mental disorders in Germany. Epidemiologic studies dealing with the prevalence of mental disorders show that the prevalence of mental disorders haven't increased. In consideration of the relative stable prevalence, currently there are only speculations about the reasons for the increasing service utilization. The capacity of psychiatric-psychosomatic-psychotherapeutic health care services is increasing. Despite the fact that capacity is increasing, in the outpatient and inpatient sector it comes apparent that there is an increasing burden, indicating that the demand for mental health care is not met by the capacity of psychiatric-psychosomatic-psychotherapeutic health care services. Health care provision by general practitioners and somatic disciplines predominate, going along with low cross-disciplinary and coordinated cooperation. So far, cooperative, intersectoral care models for mental disorders have been realized only in individual projects. Valid data are lacking, which need to reveal the causes and especially the consequences of this situation of mental health care provision and provide reference standards for an optimized, need-based care planning. For this reason, it is imperative to advance quality management for the care of mental disorders. With a view to the high rates of somatic comorbidity, an expansion of cooperative forms of mental health care appears essential.
近年来，德国因精神障碍导致的医疗保健利用率显著上升。关于精神障碍患病率的流行病学研究表明，精神障碍的患病率并未增加。考虑到患病率相对稳定，目前对于服务利用率上升的原因仅有推测。精神科-心身科-心理治疗保健服务的能力正在增强。尽管能力在增加，但在门诊和住院部门明显出现了负担加重的情况，这表明精神卫生保健的需求未得到精神科-心身科-心理治疗保健服务能力的满足。全科医生和躯体学科提供的医疗保健占主导，同时跨学科和协调合作的程度较低。到目前为止，针对精神障碍的合作性、跨部门护理模式仅在个别项目中得以实现。缺乏有效的数据，这些数据需要揭示这种精神卫生保健提供状况的原因，尤其是后果，并为优化的、基于需求的护理规划提供参考标准。因此，推进精神障碍护理的质量管理势在必行。鉴于躯体共病率较高，扩大精神卫生保健的合作形式显得至关重要。
