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[Guideline-conform psychiatric psychotherapeutic treatment for patients with schizophrenia : A normative evaluation of necessary personnel requirements].
- Source :
-
Der Nervenarzt [Nervenarzt] 2016 Mar; Vol. 87 (3), pp. 286-94. - Publication Year :
- 2016
-
Abstract
- Background: Although national treatment guidelines and current publications of the German Federal Joint Committee (Gemeinsamer Bundesausschuss) recommend cognitive behavior therapy for all patients with schizophrenia, the implementation of these recommendations in current inpatient and outpatient treatment is only rudimentary.<br />Objectives: The aim of this study was to systematically search randomized controlled studies (RCTs), meta-analyses and the guidelines of the German Association for Psychiatry and Psychotherapy, Psychosomatics and Neurology (DGPPN) and the British National Institute for Health and Clinical Excellence (NICE) in order to assess the number of personnel necessary for psychiatric and therapeutic inpatient treatment in line with present guidelines. Moreover, the number of staff required was compared with the personnel resources designated by the German psychiatry personnel regulations (Psych-PV).<br />Methods: The German and NICE guidelines, RCTs and meta-analyses were analyzed and an adequate weekly treatment plan for an inpatient unit was developed. Moreover, the number of personnel necessary to realize the treatment plan was calculated.<br />Results: In order to realize adequate inpatient treatment approximately 107 min extra for medical psychotherapeutic personnel per patient and week (of which 72 min for psychotherapy) and another 60 min for nursing staff per patient and week are required in addition to the current Psych-PV regulations. Thus, implementation in an open ward with 20 inpatients would require 3.62 positions for physicians, 0.7 positions in psychology and 12.85 positions for nursing staff (including management positions and night shifts).<br />Discussion: These evidence-based recommendations for precise specifications of inpatient treatment should lead to improved inpatient treatment in line with present guidelines. Moreover, outpatients and day patients could be included in this treatment model. The results should be considered in the construction of the future prospective payment system for inpatient psychiatric healthcare in Germany.
- Subjects :
- Adult
Aged
Chronic Disease
Clinical Competence economics
Clinical Competence standards
Germany epidemiology
Guideline Adherence economics
Guideline Adherence standards
Guideline Adherence statistics & numerical data
Hospitals, Psychiatric economics
Humans
Middle Aged
Needs Assessment economics
Personnel Staffing and Scheduling economics
Practice Guidelines as Topic
Prevalence
Psychotherapy economics
Psychotherapy statistics & numerical data
Schizophrenia economics
Schizophrenic Psychology
Utilization Review
Workforce
Young Adult
Hospitals, Psychiatric standards
Hospitals, Psychiatric statistics & numerical data
Personnel Staffing and Scheduling statistics & numerical data
Psychiatry economics
Psychiatry standards
Psychiatry statistics & numerical data
Psychotherapy standards
Schizophrenia therapy
Subjects
Details
- Language :
- German
- ISSN :
- 1433-0407
- Volume :
- 87
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Der Nervenarzt
- Publication Type :
- Academic Journal
- Accession number :
- 26820457
- Full Text :
- https://doi.org/10.1007/s00115-015-0056-y