Steinert T, Flammer E
Zentrum für Psychiatrie Südwürttemberg, Klinik für Psychiatrie und Psychotherapie I der Universität Ulm, Weingartshofer Str. 2, 88214, Ravensburg-Weissenau, Deutschland.
Nervenarzt. 2019 Jan;90(1):35-39. doi: 10.1007/s00115-018-0611-4.
The percentage of patients subjected to coercive measures has been proposed as 1 of 10 quality indicators for psychiatric inpatient treatment by the German Association of Psychiatry, Psychotherapy and Psychosomatics (DGPPN). Internationally, there are similar recommendations and corresponding reporting systems.
The registry of coercive measures of psychiatric hospitals in Baden-Württemberg that was established in 2015, yields the possibility to examine the appropriateness of this indicator, based on raw data of 108,863 cases in 2016. This study investigated how the indicator is influenced by patient variables and characteristics of hospital structure.
The percentage of cases exposed to coercive measures was strongly (r = 0.6) correlated with the percentage of involuntarily treated cases. With respect to the latter, hospitals varied widely with a range from 0.7% up to 24.1%. Specialized wards serving patients outside the catchment area with a high number of coercive measures also had a strong influence on the results of a benchmarking comparison.
The indicator is a good instrument for longitudinal evaluation of an institution; however, due to a high number of known and unknown confounding factors, it is inappropriate for the purpose of comparing psychiatric hospitals.
德国精神科、心理治疗与身心医学协会（DGPPN）已提议将接受强制治疗措施的患者比例作为精神科住院治疗的10项质量指标之一。在国际上，也有类似的建议和相应的报告系统。
巴登-符腾堡州精神科医院强制治疗措施登记册于2015年建立，基于2016年108,863例病例的原始数据，有机会检验该指标的适用性。本研究调查了该指标如何受到患者变量和医院结构特征的影响。
接受强制治疗措施的病例百分比与非自愿治疗病例的百分比密切相关（r = 0.6）。就后者而言，医院之间差异很大，范围从0.7%到24.1%。为集水区以外患者服务且采取大量强制治疗措施的专科病房，对基准比较结果也有很大影响。
该指标是对一个机构进行纵向评估的良好工具；然而，由于存在大量已知和未知的混杂因素，它不适用于精神科医院之间的比较。
