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Development and evaluation of a case group concept for inpatients with mental disorders in Germany: Using self-report and expert-rated instruments

Published online by Cambridge University Press:  16 April 2020

Sylke Andreas ,
Jörg Dirmaier ,
Timo Harfst ,
Stephan Kawski ,
Uwe Koch  and
Holger Schulz
Sylke Andreas*
Affiliation:
Department of Medical Psychology, Centre of Psychosocial Medicine, University Medical Centre Hamburg-Eppendorf, Martinistrasse 52, Building S 35, 20246Hamburg, Germany
Jörg Dirmaier
Affiliation:
Department of Medical Psychology, Centre of Psychosocial Medicine, University Medical Centre Hamburg-Eppendorf, Martinistrasse 52, Building S 35, 20246Hamburg, Germany
Timo Harfst
Affiliation:
Federal Psychotherapists' Chamber (Bundespsychotherapeutenkammer)Berlin, Germany
Stephan Kawski
Affiliation:
Department of Medical Psychology, Centre of Psychosocial Medicine, University Medical Centre Hamburg-Eppendorf, Martinistrasse 52, Building S 35, 20246Hamburg, Germany
Uwe Koch
Affiliation:
Department of Medical Psychology, Centre of Psychosocial Medicine, University Medical Centre Hamburg-Eppendorf, Martinistrasse 52, Building S 35, 20246Hamburg, Germany
Holger Schulz
Affiliation:
Department of Medical Psychology, Centre of Psychosocial Medicine, University Medical Centre Hamburg-Eppendorf, Martinistrasse 52, Building S 35, 20246Hamburg, Germany
*
*Corresponding author. Tel.: +49 40 42803 7705; fax: +49 40 42803 4940. E-mail address: sandreas@uke.uni-hamburg.de (S. Andreas).
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Abstract

The aim of this study was to evaluate a case-mix system to classify inpatients with mental disorders in Germany by means of self-report and expert-rated instruments. The use of case-mix systems enhances the transparency of performance and cost structure and can thus improve the quality of mental health care. We analysed a consecutive sample of 1677 inpatients with mental disorders from 11 hospitals using regression tree analysis. The model assigns patients to 17 groups, accounting for 17% of the variance for duration of stay. Patients with eating disorders had a longer duration of stay than patients with anxiety disorder, duration of mental illness of less than 3–5 years, lower levels of interpersonal problems and higher occupational position. The results showed that besides diagnosis, variables such as duration of illness and interpersonal problems are important for classifying inpatients with mental disorders. The results of the study should be critically reviewed regarding the empirical results of other studies and the appropriateness of case group concepts for inpatients with mental disorders.

Keywords

Psychiatric disorderQuality of carePsychotherapyCase group conceptDRG
Type
Original article
Information
European Psychiatry , Volume 24 , Issue 2 , March 2009 , pp. 105 - 111
Copyright
Copyright © Elsevier Masson SAS 2009

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