Schwarz Julian, Schmid Christine, Neumann Anne, Pfennig Andrea, Soltmann Bettina, Heinze Martin, von Peter Sebastian
Hochschulklinik für Psychiatrie und Psychotherapie an der Medizinischen Hochschule Brandenburg, Immanuel Klinik Rüdersdorf.
Institut für Psychologie und Arbeitswissenschaft, Fachgebiet Arbeitswissenschaft, Technische Universität Berlin.
Psychiatr Prax. 2022 Mar;49(2):71-79. doi: 10.1055/a-1421-3283. Epub 2021 Apr 26.
Since 2013, flexible and integrative psychiatric treatment models (FIT64b) have been set up in 22 German hospitals. FIT64b is based on a global treatment budget (GTB) covering costs for all psychiatric hospital services and is related to the number of patients treated. As part of the "PsychCare"-study we are examining incentives, requirements and challenges which relate to the introduction of FIT64b.
Expert interviews and focus groups (n = 29) were led with management and controlling staff from 7 FIT64b adopting hospitals and 3 statutory health insurance funds (SHI). A thematic analysis was conducted.
A central component for the introduction of a GTB is a cooperative relation based on mutual trust between hospitals and SHI. Challenging are, above all, performance documentation and performance control of cross-sectoral treatment as well as the parallel structure of FIT64b and standard care.
Apart from several surmountable obstacles to implementation, the GTB seems to be a strong driver for the future-oriented transformation of psychiatric hospital services in Germany. In the further development of GTB, the obligation to contract with all SHI should be considered.
自2013年以来，德国22家医院建立了灵活综合的精神科治疗模式（FIT64b）。FIT64b基于一项涵盖所有精神科医院服务费用的全球治疗预算（GTB），并与接受治疗的患者数量相关。作为“心理护理”研究的一部分，我们正在研究与引入FIT64b相关的激励措施、要求和挑战。
对7家采用FIT64b模式的医院以及3家法定医疗保险基金（SHI）的管理和控制人员进行了专家访谈和焦点小组讨论（n = 29）。进行了主题分析。
引入GTB的一个核心要素是医院与SHI之间基于相互信任的合作关系。最具挑战性的是跨部门治疗的绩效记录和绩效控制，以及FIT64b与标准护理的并行结构。
除了一些可克服的实施障碍外，GTB似乎是德国精神科医院服务面向未来转型的强大驱动力。在GTB的进一步发展中，应考虑与所有SHI签订合同的义务。
