[Changes in mental health care by a regional budget: results of a pilot Project in Schleswig-Holstein (Germany)]

Psychiatr Prax. 2010 Oct;37(7):335-42. doi: 10.1055/s-0030-1248438. Epub 2010 Aug 11.
[Article in German]

Abstract

Objectives: In a region of Schleswig-Holstein, a regional budget was used to investigate which structural changes would be brought about by a financial plan which enables (clinical) treatment that defies rigid financial limits and makes flexible treatment in various settings possible.

Results: In 5 years, the number of inpatient treatment places in the care region was reduced considerably. The length of stay per patient and year decreased by 25 %. Day care and outpatient treatment offers were expanded substantially and new treatment concepts were established. The quality of treatment remained safeguarded.

Conclusions: A regional budget is suitable for bringing about fundamental changes in terms of content and structure in psychiatric care. The result is clearly improved flexibility as compared to previous care structures; incentives for disorders are reduced. The principle "outpatient before inpatient" is strengthened. The financial plan can be transposed onto other regions, whereby modifications according to the structure of the care region seem necessary.

MeSH terms

  • Bed Occupancy / economics
  • Bed Occupancy / statistics & numerical data
  • Budgets / statistics & numerical data*
  • Budgets / trends
  • Community Mental Health Services / economics
  • Community Mental Health Services / statistics & numerical data
  • Community Mental Health Services / trends
  • Cost Control / economics
  • Cost Control / statistics & numerical data
  • Cost Control / trends
  • Delivery of Health Care / economics*
  • Delivery of Health Care / statistics & numerical data
  • Delivery of Health Care / trends
  • Financing, Government / economics
  • Financing, Government / statistics & numerical data
  • Financing, Government / trends
  • Germany
  • Health Care Rationing / economics*
  • Health Care Rationing / statistics & numerical data
  • Health Care Rationing / trends
  • Health Services Accessibility / economics
  • Health Services Accessibility / statistics & numerical data
  • Health Services Accessibility / trends
  • Health Services Research
  • Humans
  • Length of Stay / economics
  • Length of Stay / statistics & numerical data
  • Length of Stay / trends
  • Mental Disorders / diagnosis
  • Mental Disorders / economics*
  • Mental Disorders / epidemiology
  • Mental Disorders / therapy
  • Mental Health Services / economics*
  • Mental Health Services / statistics & numerical data
  • Mental Health Services / trends
  • Models, Economic
  • National Health Programs / economics*
  • National Health Programs / statistics & numerical data
  • Outcome and Process Assessment, Health Care / economics
  • Outcome and Process Assessment, Health Care / statistics & numerical data
  • Outcome and Process Assessment, Health Care / trends
  • Patient Readmission / economics
  • Patient Readmission / statistics & numerical data
  • Patient Readmission / trends
  • Pilot Projects
  • Psychotherapy / economics
  • Psychotherapy / statistics & numerical data
  • Psychotherapy / trends
  • Quality Assurance, Health Care / economics
  • Quality Assurance, Health Care / statistics & numerical data
  • Quality Assurance, Health Care / trends
  • Regional Medical Programs / economics*
  • Regional Medical Programs / statistics & numerical data
  • Reimbursement Mechanisms / economics
  • Reimbursement Mechanisms / statistics & numerical data
  • Reimbursement Mechanisms / trends
  • Utilization Review / statistics & numerical data