Senkal A, Brückner-Bozetti P, Lingenfelder M, Blume A, Klode C, Steinert T
Forum für Gesundheitswirtschaft gGmbH, Scharnhorststr. 76, 28211, Bremen, Deutschland.
Institut für Health Care Management, Philipps-Universität Marburg, Marburg, Deutschland.
Nervenarzt. 2019 Mar;90(3):293-298. doi: 10.1007/s00115-018-0600-7.
The German Law for the Development of Care and Funding for Psychiatric and Psychosomatic Services (PsychVVG) has established a new regulation for the mental healthcare system. In the future, characteristics of hospitals and catchment areas will be an elementary part of negotiations on remuneration.
The aim of this study was to identify structural and regional characteristics of psychiatric hospitals in Germany that contribute to increased average costs according to the views of clinical managers and directors.
In this study 37 guided expert interviews were conducted with business managers, financial controllers, leading medical and nursing personnel from psychiatric hospitals and the characteristics relevant for the budget and increased average costs were collated.
Important factors with top priority were hospital infrastructure, characteristics of the catchment area and specialties of inpatient services provided. Obligatory service for a defined catchment area, increased documentation requirements and infrastructure of buildings and grounds were estimated as being associated with the highest additional financial expenditure.
It is a challenge for clinics to prove increased average costs due to the respective hospital structural and regional characteristics. This study shows which characteristics should be considered as most cost-relevant from the perspective of hospital management.
德国《精神科及身心科服务发展与资助法》（PsychVVG）为精神卫生保健系统制定了一项新规定。未来，医院和服务区域的特征将成为薪酬谈判的基本组成部分。
本研究旨在根据临床管理人员和院长的观点，确定德国精神病医院中导致平均成本增加的结构和区域特征。
本研究对来自精神病医院的业务经理、财务主管、首席医疗和护理人员进行了37次专家访谈，并整理了与预算和平均成本增加相关的特征。
首要的重要因素是医院基础设施、服务区域特征和提供的住院服务特色。为特定服务区域提供的强制性服务、增加的文件记录要求以及建筑物和场地的基础设施被认为与最高的额外财务支出相关。
各诊所要证明因各自医院的结构和区域特征导致平均成本增加是一项挑战。本研究表明，从医院管理的角度来看，哪些特征应被视为与成本最相关。
