Spezifische Merkmale zur Einstufung der Modellversorgung nach § 64b SGB V

Peter, Sebastian von; Ignatyev, Yuriy; Indefrey, Sonja; Johne, Jakob; Schwarz, Julian; Timm, Jürgen; Heinze, Martin

doi:10.1007/s00115-017-0459-z

Cited by 26 publications

(38 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…All eligible patients were given a comprehensive description of the project, were informed that their participation or refusal would not affect their care, and provided written consent, with guaranteed anonymity. Prior to the main assessment we undertook preliminary exploratory studies to optimize study materials (28, 29).…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Evaluation of Flexible and Integrative Psychiatric Treatment Models in Germany—A Mixed-Method Patient and Staff-Oriented Exploratory Study

et al. 2019

View full text Add to dashboard Cite

Contrary to the practice in some countries, access to flexible and integrated forms of psychiatric care (FIT models) is limited in Germany. Several legislations have been introduced to improve this situation, notably the recent §64b (flexible and integrative treatment model; FIT64b) of the German Social Code, which allows for a capitation-based accounting of fees for services. The aim of this study was to explore the effects of FIT64b implementation on various stakeholders (patients, informal caregivers and staff) in 12 psychiatric hospital departments across Germany. Structural as well as quantitative and qualitative data are included, with integration of different methodological approaches. In all departments, the implementation of the new accounting system resulted into a relatively stable set of structural and processual changes where rigid forms of mainly inpatient care shifted to more flexible and integrated types of outpatient and outreach treatments. These changes were more likely to be perceived by patients and staff, and likewise received better evaluations, in those departments showing higher level or longer duration of implementation. Patients' evaluations, furthermore, were largely influenced by the advent of continuous forms of care, better accessibility, and by their degree of autonomy in steering of their services.

show abstract

Section: Methodsmentioning

confidence: 99%

“…Due to large differences in FIT64b practices between the 12 sites, we had to implement new strategies for integrating data sources. A description of our methodological challenges can be found elsewhere (27–29); we now report the main results and conclusions of the multi-center and mixed method evaluation study “EvaMod64b.”…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Flexible and Integrative Psychiatric Treatment Models in Germany—A Mixed-Method Patient and Staff-Oriented Exploratory Study

et al. 2019

View full text Add to dashboard Cite

show abstract

“…Im Rahmen einer Vorstudie wurden zunächst elf spezifische Merkmale von MV entwickelt [24]. Diese wurden operationalisiert und zur Bestimmung des Implementierungsgrades in den Studienkliniken herangezogen [14,25]. Ebenfalls auf Grundlage dieser Merkmale wurde ein Fragebogen zur Beurteilung settingübergreifender Versorgung in der Psychiatrie für Patienten entwickelt und validiert ("SEPICC-Scale") [26].…”

Section: Studiendesignunclassified

Analyse von Implementierungsmerkmalen psychiatrischer Modellvorhaben (nach §64b SGB V) in Schleswig-Holstein im Vergleich zum Bundesgebiet

et al. 2019

View full text Add to dashboard Cite

Zusammenfassung Ziel Bundesweit gibt es 19 Modellvorhaben nach §64b SGB V (MV), die eine settingübergreifende und flexible psychiatrische Behandlung anbieten. In Schleswig-Holstein (SH) haben sich fünf dieser Modelle gebildet. In einer vergleichenden Analyse wird die Implementierung der MV in SH gegenüber dem Bundesgebiet untersucht. Methodik Standardisierte Befragung von 383 Patienten aus sieben Kliniken, davon drei aus SH, zur Beurteilung der Modellversorgung. Es wurden Struktur-, Leistungs- sowie Daten zum Implementierungsstand von MV in SH und den übrigen Bundesländern analysiert. Ergebnisse MV in SH weisen eine stärkere Ausprägung modellspezifischer Merkmale und einen höheren Implementierungsgrad gegenüber der Vergleichsgruppe auf. Sie befinden sich in öffentlicher Trägerschaft und sind mit allen Krankenkassen verhandelt. Patienten dieser MV werden häufiger ambulant oder aufsuchend behandelt, verfügen über mehr Erfahrung mit spezifischen Aspekten der MV und bewerten diese besser. Schlussfolgerung Die Implementierung der MV in SH kann als besonders erfolgreich angesehen werden. Unter anderem scheint die Unterstützung der Landespolitik eine entscheidende Triebkraft hierfür zu sein.

show abstract

“…The programme components of FIT64b aim to rapidly shift patients from inpatient to outpatient settings, to flexibly manage care across settings, to assure continuity of care provided by multidisciplinary teams, to provide therapeutic group sessions across all settings, to conduct outreach home care, to involve informal caregivers, to assure accessibility of services, sovereign steering of services, collaboration across sectors, and to expand professional expertise . Like in most international FIT models such as assertive community treatment (ACT), home treatment (HT), and crisis resolution teams (CRT), a multidisciplinary team constitutes the core of the FIT64b models, including psychiatrists, psychiatric nurses, psychologists, social worker, and occupational therapists, who collectively take the responsibility for patients.…”

Section: Introductionmentioning

confidence: 99%

Hospital length of stay among older people treated with flexible and integrative psychiatric service models in Germany

Ignatyev

Mundt

Peter

et al. 2019

Int J Geriat Psychiatry

View full text Add to dashboard Cite

Objective Since 2012, a new law (§64b, Book V of the Social Security Code [SGB V]) regulates the implementation of flexible and integrative psychiatric treatment projects (FIT64b) in Germany. FIT64b allows rapid discharge of patients from inpatient to outpatient settings and cost reductions of hospital stays. Several psychiatric centres exclusively provide FIT64b; others provide FIT64b alongside with standard health care. The aim of the study was to assess the average hospital length of stay (AHLS) of older patients with mental illness included in FIT64b projects. Methods A secondary data analysis was conducted using administrative data from eight German mental health centres providing FIT64b. The effects of gender, age, type of centre, and main diagnosis on AHLS were calculated for all older patients with age 65 years or older (n = 3495) treated in FIT64b in the year 2016. Data were analysed with descriptive statistics and robust multiway procedures. Results The AHLS of older people with mental illness was 4.8 (SD = 11.5) days. The AHLS was shorter in centres exclusively providing FIT64b than in centres providing FIT64b alongside with standard health care: 3.2 (SD = 6.4) vs 8.4 (SD = 17.8) days, P = .001. This difference was particularly marked among patients with schizophrenia spectrum disorders, mood disorders, and neurotic, stress‐related, and somatoform disorders. Conclusions FIT64b relates to very short AHLS even among older people. Centres using FIT64b alongside with standard health care usually provide standard care to most patients, which could lead to lower fidelity in the implementation of FIT64b.

show abstract

Spezifische Merkmale zur Einstufung der Modellversorgung nach § 64b SGB V

Abstract: These components can be used for implementation, quality management and evaluation of projects for treatment models according to § 64b SGB V.

Cited by 26 publications

References 16 publications

Evaluation of Flexible and Integrative Psychiatric Treatment Models in Germany—A Mixed-Method Patient and Staff-Oriented Exploratory Study

Evaluation of Flexible and Integrative Psychiatric Treatment Models in Germany—A Mixed-Method Patient and Staff-Oriented Exploratory Study

Analyse von Implementierungsmerkmalen psychiatrischer Modellvorhaben (nach §64b SGB V) in Schleswig-Holstein im Vergleich zum Bundesgebiet

Hospital length of stay among older people treated with flexible and integrative psychiatric service models in Germany

Contact Info

Product

Resources

About