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Fortschr Neurol Psychiatr 2001; 69(1): 19-31
DOI: 10.1055/s-2001-10438
ÜBERSICHT
Georg Thieme Verlag Stuttgart · New York

Die Dauer der stationären psychiatrischen Behandlung

Eine Übersicht über Methodik, Einflussfaktoren und AuswirkungenD. Richter
  • Westf. Klinik für Psychiatrie und Psychotherapie Münster(Leitung: PD Dr. med. Thomas Reker)
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Publication History

Publication Date:
31 December 2001 (online)

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Zusammenfassung:

Die Dauer der stationären psychiatrischen Behandlung ist ein umstrittenes Thema zwischen Kliniken und Kostenträgern, das überwiegend unter ökonomischen Fragestellungen diskutiert wird. Diese Arbeit hat das Ziel, die empirischen Befunde über die Behandlungsdauer zu sichten, um neben den ökonomischen Bedingungen auch fachliche Gesichtspunkte berücksichtigen zu können. Zwei zentrale Fragestellungen lassen sich aus der Literatur identifizieren: 1. Welche Faktoren beeinflussen die Dauer der Behandlung? 2. Welche Auswirkungen hat die Dauer der Behandlung auf den Gesundheitsstatus der Patienten? Die Ergebnisse zeigen, dass die Behandlungsdauer weniger durch die Diagnose und durch soziodemographische Merkmale bestimmt wird als vielmehr durch den Behandlungsverlauf und organisatorische Charakteristika der Einrichtungen. Insbesondere jüngere Arbeiten finden positive Effekte längerer Behandlungen für den Gesundheitsstatus der Patienten. Studien über längerfristige Reduktionen der Behandlungsdauer lassen auf einen Zusammenhang zwischen kürzeren Behandlungen und steigenden Wiederaufnahmeraten schließen. Es wird gefolgert, dass die Reduktion der Behandlungsdauer in der stationären Psychiatrie sorgfältig evaluiert werden sollte, um negative Konsequenzen für den Gesundheitsstatus der Patienten auszuschließen.

Psychiatric Inpatient Duration of Stay - A Review of Methods, Influences and Consequences:

Duration of inpatient psychiatric treatment is considerably under discussion between hospitals and payers. This article aims at reviewing the scientific evidence on the topic of psychiatric inpatient duration of stay. Two general research questions can be identified from the literature: 1. Which factors do influence duration of stay? 2. Which consequences does duration of psychiatric treatment have on patients' health status? Results show that duration of stay is less influenced by psychiatric diagnosis and sociodemographic items but more by the process of treatment and by organizational characteristics of the institutions. More recent studies generally find positive effects of longer treatment episodes. Studies about the consequences of duration of stay show a relation between reductions in duration of treatment and increasing readmissions. It is concluded that reductions in duration of inpatient treatment must be carefully evaluated to prevent negative consequences for patients' health status.

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Dr. phil D Richter

Westf. Klinik für Psychiatrie und Psychotherapie Münster

Postfach 862048046 Münster

Email: E-mail: d.richter@wkp-muenster.de

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