Soltmann Bettina, Neumann Anne, March Stefanie, Weinhold Ines, Häckl Dennis, Kliemt Roman, Baum Fabian, Romanos Marcel, Schwarz Julian, von Peter Sebastian, Ignatyev Yuriy, Arnold Katrin, Swart Enno, Heinze Martin, Schmitt Jochen, Pfennig Andrea
Department of Psychiatry and Psychotherapy, Carl Gustav Carus University Hospital, Technische Universität Dresden, Dresden, Germany.
Center of Evidence-Based Health Care, Medical Faculty Carl Gustav Carus, Carl Gustav Carus University Hospital, Technische Universität Dresden, Dresden, Germany.
Front Psychiatry. 2021 Jun 1;12:659773. doi: 10.3389/fpsyt.2021.659773. eCollection 2021.
New cross-sectoral mental health care models have been initiated in Germany to overcome the fragmentation of the German health care system. Starting in 2013, flexible and integrative psychiatric care model projects according to §64b SGB V German Social Law (FIT64b) have been implemented. The study "PsychCare" combines quantitative and qualitative primary data with routine health insurance data for the evaluation of these models. Effects, costs and cost-effectiveness from the perspectives of patients, relatives and care providers are compared with standard care. Additionally, quality indicators for a modern, flexible and integrated care are developed. This article describes the rationale, design and methods of the project. "PsychCare" is built on a multiperspective and multimethod design. A controlled prospective multicenter cohort study is conducted with three data collection points (baseline assessment, follow-up after 9 and 15 months). A total of 18 hospitals (10 FIT64b model and 8 matched control hospitals) have consecutively recruited in- and outpatients with pre-specified common and/or severe psychiatric disorders. Primary endpoints are differences in change of health-related quality of life and treatment satisfaction. Sociodemographic and service receipt data of the primary data collection are linked with routine health insurance data. A cost-effectiveness analysis, a mixed method, participatory process evaluation by means of qualitative surveys and the development of quality indicators are further elements of "PsychCare." The results based on data from different methodological approaches will provide essential conclusions for the improvement of hospital based mental health care in Germany. This should result in the identification of key FIT64b elements that can be efficiently implemented into standard care in Germany and re-structure the care strongly aligned to patient needs. German Clinical Trial Register, identifier DRKS 00022535.
德国已启动新的跨部门精神卫生保健模式，以克服德国医疗保健系统的碎片化问题。自2013年起，根据德国社会法典第五编第64b条（FIT64b）实施了灵活综合的精神科护理模式项目。“PsychCare”研究将定量和定性的原始数据与常规医疗保险数据相结合，以评估这些模式。从患者、亲属和护理提供者的角度比较了这些模式与标准护理的效果、成本和成本效益。此外，还制定了现代、灵活和综合护理的质量指标。本文描述了该项目的基本原理、设计和方法。“PsychCare”基于多视角和多方法设计。进行了一项对照前瞻性多中心队列研究，有三个数据收集点（基线评估、9个月和15个月后的随访）。共有18家医院（10家FIT64b模式医院和8家匹配的对照医院）连续招募患有预先指定的常见和/或严重精神疾病的住院和门诊患者。主要终点是健康相关生活质量变化和治疗满意度的差异。原始数据收集的社会人口统计学和服务接受数据与常规医疗保险数据相关联。成本效益分析、通过定性调查进行的混合方法参与式过程评估以及质量指标的制定是“PsychCare”的其他要素。基于不同方法学途径的数据得出的结果将为改善德国医院精神卫生保健提供重要结论。这应能确定可有效纳入德国标准护理的FIT64b关键要素，并根据患者需求大力调整护理结构。德国临床试验注册中心，标识符DRKS 00022535。
