von Wietersheim Jörn, Knoblauch Jamie Dwayne, Rottler Edit, Weiß Heinz, Hartmann Armin, Rochlitz Peter, Völker Alexander, Scheidt Carl Eduard, Beutel Manfred E, Eckhardt-Henn Annegret, Zeeck Almut
Klinik für Psychosomatische Medizin und Psychotherapie, Universitätsklinikum Ulm.
Abteilung für Psychosomatische Medizin und Psychotherapie, Robert-Bosch-Krankenhaus, Stuttgart.
Psychother Psychosom Med Psychol. 2020 Jul;70(7):283-291. doi: 10.1055/a-1038-4708. Epub 2019 Dec 10.
Several therapeutic treatments like individual psychotherapy, group therapy, creative therapies and talks with the nursing staff are components in an inpatient psychosomatic (psychotherapeutic) treatment or a psychosomatic day hospital treatment. In Germany, these therapies have to be documented by the administration with so called OPS-Codes. These codes are reported to the Institute for Reimbursement in Hospitals (InEK). With the data of the INDDEP-study it should be investigated how the therapies of 7 hospitals and 8 day-hospitals compare to each other. In addition, it should be studied, if the amount of the documented therapies is connected to the outcome in these hospitals. In the INDDEP-study, data of patients with major depression were assessed at 4 measurement points (admission, discharge, 3 months and 12 months follow up). In addition, the OPS codes of the treatments were documented. The results show that it is possible to get a rough estimation of the psychotherapeutic doses by the OPS-codes. The results show significant differences between the hospitals in terms of the intensity and professional group composition of the treatments. This result is confirmed for in-patient and day hospital treatments. Correlation analyses showed no significant correlation between the total amount of therapy and the improvement in depressive symptoms. It is assumed that there are moderating variables (patient-, therapy and process-related) which moderate the relation between doses and outcome. This should be identified in further studies.
多种治疗方法,如个体心理治疗、团体治疗、创意治疗以及与护理人员的谈话,都是住院身心(心理治疗)治疗或身心日间医院治疗的组成部分。在德国,这些治疗方法必须由管理部门用所谓的OPS编码进行记录。这些编码会上报给医院报销研究所(InEK)。利用INDDEP研究的数据,应该调查7家医院和8家日间医院的治疗方法如何相互比较。此外,还应该研究记录的治疗量是否与这些医院的治疗结果相关。在INDDEP研究中,对重度抑郁症患者的数据在4个测量点(入院、出院、3个月和12个月随访)进行了评估。此外,还记录了治疗的OPS编码。结果表明,通过OPS编码可以对心理治疗剂量进行大致估算。结果显示,各医院在治疗强度和专业团队组成方面存在显著差异。住院治疗和日间医院治疗均证实了这一结果。相关性分析表明,治疗总量与抑郁症状改善之间无显著相关性。据推测,存在调节变量(与患者、治疗和过程相关)来调节剂量与结果之间的关系。这一点应在进一步研究中加以确定。