Bschor, Tom, Hoss, Anne, Baethge, Christopher and Rauchensteiner, Stephan (2020). Changes in Patient and Disease Characteristics in a Psychiatric Clinic After Adopting the Model of Sectorized Mandatory Care. Gesundheitswesen, 82 (7). S. 586 - 594. STUTTGART: GEORG THIEME VERLAG KG. ISSN 1439-4421

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Abstract

BackgroundRegional 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. MethodChanges 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). ResultsOn 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%). ConclusionAfter 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.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Bschor, TomUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hoss, AnneUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Baethge, ChristopherUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Rauchensteiner, StephanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-327686
DOI: 10.1055/a-0795-3350
Journal or Publication Title: Gesundheitswesen
Volume: 82
Number: 7
Page Range: S. 586 - 594
Date: 2020
Publisher: GEORG THIEME VERLAG KG
Place of Publication: STUTTGART
ISSN: 1439-4421
Language: German
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
GLOBAL ASSESSMENT; VALIDITY; SCALEMultiple languages
Public, Environmental & Occupational HealthMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/32768

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