Kerkemeyer L, Mostardt S, Biermann J, Wasem J, Neumann A, Walendzik A, Jahn R, Bartels C, Falkai P, Brannath W, Breunig-Lyriti V, Mester B, Timm J, Wobrock T
Institute for Health Care Management and Research, University of Duisburg-Essen, Schützenbahn 70, 45127, Essen, Germany,
Eur Arch Psychiatry Clin Neurosci. 2015 Mar;265(2):155-62. doi: 10.1007/s00406-014-0508-6. Epub 2014 Jun 7.
Concept and design of an independent scientific evaluation of different pathways of care for schizophrenia patients in Germany with respect to effectiveness and efficiency are presented. In this prospective, observational study, schizophrenia patients receiving an integrated care treatment, the intervention group (IG), are compared with patients under routine care conditions treated by the same physician (first control group, CG 1). A second control group (CG 2) of patients treated by office-based psychiatrists not participating in the integrated care program will be recruited and their data compared with the two other groups. The total amount of psychiatric hospital days after 12 months is defined as primary outcome parameter. Secondary outcome parameters comprise the frequency of psychiatric inpatient readmissions, severity of schizophrenia symptoms, remission rates and quality of life. Patients undergo assessments at baseline, month 6 and 12 using standardized and experimental questionnaires. Routine data of a regional German social health insurance fund complement information on included patients. Additionally, a cost-effectiveness and cost-utility analysis will be performed. Until now, 137 psychiatrists included 980 patients in the integrated care project in Lower Saxony, Germany, and 47 psychiatrists (IG and both CGs) are willing to participate in the independent evaluation. For the first time, a prospective observational controlled evaluation study of a countrywide integrated care project planning to recruit 500 schizophrenia patients has started using comprehensive assessments as well as routine data of a social health insurance fund.
介绍了对德国精神分裂症患者不同护理途径的有效性和效率进行独立科学评估的概念和设计。在这项前瞻性观察研究中，将接受综合护理治疗的精神分裂症患者（干预组，IG）与由同一位医生进行常规护理的患者（第一对照组，CG 1）进行比较。将招募由未参与综合护理项目的门诊精神科医生治疗的患者作为第二对照组（CG 2），并将他们的数据与其他两组进行比较。将12个月后精神病住院天数的总量定义为主要结局参数。次要结局参数包括精神病住院再入院频率、精神分裂症症状严重程度、缓解率和生活质量。患者在基线、第6个月和第12个月使用标准化和实验性问卷进行评估。德国一个地区社会健康保险基金的常规数据补充了纳入患者的信息。此外，还将进行成本效益和成本效用分析。到目前为止，德国下萨克森州有137名精神科医生将980名患者纳入了综合护理项目，47名精神科医生（IG和两个CG）愿意参与独立评估。一项计划招募500名精神分裂症患者的全国性综合护理项目的前瞻性观察对照评估研究首次启动，该研究使用了综合评估以及社会健康保险基金的常规数据。
