Adjustment of the German Prospective Payment System for Psychiatric and Psychosomatic Facilities: Does PEPP Provides a Suitable Basis? Results of a Descriptive Comparative Study

Abstract

Introduction

In Germany a consistent, performance-oriented, flat-rate remuneration system based on per-day payments for inpatient and day patient hospital services for psychiatric and psychosomatic facilities (PEPP) is developed. The Klinikum Chemnitz gGmbH decided in 2013 to participate in the optional PEPP introducing phase and acts as a PEPP cost accounting hospital.

Objectives

Due to a controversial discussion by the psychiatric experts, an adjustment of the hitherto only performance-based to a budget-oriented system based on PEPP is planned in 2017.

Aims

This paper discusses if the current PEPP remuneration system enables an appropriate recognition and measurement of services.

Methods

Descriptive analyses were performed by comparing inpatient and day patient treatment at a therapy oriented psychiatric unit and the emergency psychiatric unit in 2015. The evaluation primarily focused on the criteria of “staffing level and structure”, “imaging of services by German procedure classification (OPS) according to PEPP”, “PEPP remuneration”.

Results

Our findings (Table 1) show that in 2015 the PEPP remuneration system provided an appropriate recognition of unit-specific services in emergency psychiatry (e.g., 1 to 1 care, intensive care treatment), but services of board certified therapeutic staff were recognized inadequately in consequence of the definition of therapy by the OPS catalogue.

Conclusion

Further development of payment system should implicate changes in the definition of therapy according to scientific guidelines and the pay for performance concept.

Table 1

Disclosure of interest

Activity as a speaker, Janssen-Cilag GmbH.