灵活的,综合的,以人为中心的精神科护理通过全球治疗预算:多视角研究的结果。

IF 1.1 4区 医学 Q4 CLINICAL NEUROLOGY
Andrea Pfennig, Bettina Soltmann, Anne Neumann, Martin Heinze, Roman Kliemt, Dennis Häckl, Enno Swart, Fabian Baum, Yuri Ignatyev, Julian Schwarz, Denise Kubat, Ines Weinhold, Tarcyane Barata Garcia, Sebastian von Peter, Jochen Schmitt
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引用次数: 0

摘要

背景:为了克服德国支离破碎的护理提供,根据德国社会法典(SGB) V§64b实施了灵活的综合精神病学护理(FIT)模式项目。目的:对前瞻性交叉模型、对照、多视角/多方法研究心理护理的结果进行了介绍和讨论,并与基于法定健康保险(SHI)的研究数据进行了讨论。材料和方法:PsychCare采用多方法和混合方法设计。在研究开始(M-I)和15个月后(M-II)获得18家精神病院(n = 10 FIT; n = 8匹配常规治疗- tau)的主要数据。主要结局为治疗满意度和健康相关生活质量。次要结局包括康复、临床决策、症状严重程度、医疗保健利用和成本、护理需求和经验以及护理者负担。参与式过程评价评估了与过程、结构和经验相关的组成部分。结果:FIT组患者(n = 595)的治疗满意度显著高于对照组(ZUF-8: 26.3 ±4.36 vs. 24.9 ±4.70;p 0.05);FIT护理人员在数字上更满意。在第一阶段和第二阶段,FIT的直接医疗费用都明显较低。护理类型与FIT组件的实施程度相关。将primary数据和SHI数据连接起来是可行的。结论:心理护理显示FIT在横断面治疗满意度、康复和照顾者满意度方面具有优势。与标准护理相比,长期FIT的成功需要进一步评估。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Flexible, integrated, and person-centered psychiatric care through global treatment budgets: results of the multiperspective study PsychCare.

Background: To overcome fragmented care provision in Germany, flexible, integrated psychiatric care (FIT) model projects according to § 64b of the German Social Code Book (SGB) V were implemented.

Objectives: The results of the prospective cross-model, controlled, multiperspective/multimethod study PsychCare are presented and discussed along with data from statutory health insurance (SHI)-based research.

Materials and methods: PsychCare applied a multi- and mixed-method design. Primary data were acquired in 18 psychiatric hospitals (n = 10 FIT; n = 8 matched treatment as usual-TAU) at study start (M-I) and 15 months later (M-II). Main outcomes were treatment satisfaction and health-related quality of life. Secondary outcomes included recovery, clinical decision-making, symptom severity, healthcare utilization and costs, needs and experiences with care, and caregiver burden. Participatory process evaluation assessed process-, structure-, and experience-related components.

Results: Patients in FIT (n = 595) had significantly higher treatment satisfaction (ZUF-8: 26.3 ± 4.36 vs. 24.9 ± 4.70; p < 0.001) and recovery (RAS‑R total: 134 ± 35.8 vs. 119 ± 54.3; p < 0.001) at M‑I compared to TAU patients (n = 555), despite comparable symptom severity. About 50% of patients reported high satisfaction with clinical decision-making (p > 0.05); FIT caregivers were numerically more satisfied. Direct medical costs were significantly lower in FIT both at M‑I and M‑II. Type of care was associated with the degree of implementation of FIT components. Linking primary and SHI data was feasible.

Conclusion: PsychCare showed that FIT was superior in cross-sectional treatment satisfaction, recovery, and caregiver satisfaction with suggested cost-effectiveness. Long-term FIT success compared to standard care needs further assessment.

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来源期刊
Nervenarzt
Nervenarzt 医学-精神病学
CiteScore
2.50
自引率
18.20%
发文量
169
审稿时长
4-8 weeks
期刊介绍: Der Nervenarzt is an internationally recognized journal addressing neurologists and psychiatrists working in clinical or practical environments. Essential findings and current information from neurology, psychiatry as well as neuropathology, neurosurgery up to psychotherapy are presented. Review articles provide an overview on selected topics and offer the reader a summary of current findings from all fields of neurology and psychiatry. Freely submitted original papers allow the presentation of important clinical studies and serve the scientific exchange. Review articles under the rubric ''Continuing Medical Education'' present verified results of scientific research and their integration into daily practice.
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