[Changes in Patient and Disease Characteristics in a Psychiatric Clinic After Adopting the Model of Sectorized Mandatory Care].

Autor:	Bschor T; Schlosspark-Klinik, Abt. Psychiatrie, Berlin.; Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden., Hoß A; PP.rt, Klinik für Psychiatrie, Psychotherapie und Psychosomatik, Reutlingen., Baethge C; Klinik für Psychiatrie und Psychotherapie, Uniklinik Köln, Köln., Rauchensteiner S; Schlosspark-Klinik, Abt. Psychiatrie, Berlin.
Jazyk:	němčina
Zdroj:	Gesundheitswesen (Bundesverband der Arzte des Offentlichen Gesundheitsdienstes (Germany)) [Gesundheitswesen] 2020 Jul; Vol. 82 (7), pp. 586-593. Date of Electronic Publication: 2018 Dec 20.
DOI:	10.1055/a-0795-3350
Abstrakt:	Background: Regional mandatory care is a special feature of psychiatric inpatient care in Germany. There is practically no systematic information on the changes in patient and disease characteristics a clinic is confronted with when adopting regional mandatory care. Method: Changes in inpatient characteristics were assessed by analyzing the whole set of the basic documentation inpatient data (BADO) of 2 years at Schlosspark-Klinik in Berlin (SPK) which switched to mandatory care in one regional sector in the year between the 2 years. We analyzed 863 vs. 1345 cases for the 2 years (without vs. with mandatory care). Results: On average, patients were younger (M=50 vs. 48 y, p<0.05), fewer patients lived independently (97 vs. 89%, p<0.05), fewer were in partnership (42 vs. 29%, p<0.05), and fewer were employed (34 vs. 28%, p<0.05). The percentage of emergency cases (13 vs. 35%, p<0.001) and compulsory admissions (0.2 vs. 8.5%, p<0.001) was higher after adopting mandatory care. More patients terminated their treatment without their physician's consent (9 vs. 22%, p<0.001). There was a proportional increase of F1x ICD-10 diagnoses (11 vs. 22%) and F2x (14 vs. 20%), while there was a proportional decrease of F3x (38 vs. 30%) and F4x diagnoses (26 vs. 13%). Conclusion: After adoption of regional mandatory care, clinical structures need to be adjusted to deal with an increase in emergency cases and a larger number of patients with unfavorable sociodemographic and disease characteristics. To be able to do this, clinics should be equipped with the required organizational and financial means. Competing Interests: Alle Autoren erklären, keine Interessenkonflikte im Sinne der Richtlinien des International Committee of Medical Journal Editors zu haben. (© Georg Thieme Verlag KG Stuttgart · New York.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu