Guideline-conform inpatient psychiatric psychotherapeutic treatment of chronic depression: Normative personnel requirements

• Published in: Nervenarzt 2016-03, Vol.87 (3), p.278-285
• Main Authors: Schnell, K, Hochlehnert, A, Berger, M, Wolff, J, Radtke, M, Schramm, E, Normann, C, Herpertz, S C
• Format: Article
• Language: ger
• Subjects: Adult; Aged; Chronic Disease; Clinical Competence - economics; Clinical Competence - standards; Depression - economics; Depression - psychology; Depression - therapy; Female; Germany - epidemiology; Guideline Adherence - economics; Guideline Adherence - standards; Guideline Adherence - utilization; Hospitals, Psychiatric - economics; Hospitals, Psychiatric - standards; Hospitals, Psychiatric - utilization; Humans; Male; Middle Aged; Needs Assessment - economics; Personnel Staffing and Scheduling - economics; Personnel Staffing and Scheduling - utilization; Practice Guidelines as Topic; Prevalence; Psychiatry - economics; Psychiatry - manpower; Psychiatry - standards; Psychiatry - statistics & numerical data; Psychotherapy - economics; Psychotherapy - standards; Psychotherapy - statistics & numerical data; Utilization Review; Young Adult
• ISSN: 1433-0407
• DOI: 10.1007/s00115-016-0084-2

Chronic depression is a frequent mental disorder representing a significant subjective and economic burden. Effective disorder-specific treatment of chronic depression presupposes sufficient funding of treatment resources. Definition of normative needs of personnel resources for guideline-compliant and evidence-based inpatient treatment of chronic depression based on treatment duration and intensity. The personnel resources determined were compared to the resources provided on the basis of the existing reimbursement system (Psych-PV) in Germany. Resources determined according to national treatment guidelines and empirical evidence were compared to personnel resources dictated by the German Psych-PV reimbursement algorithm. The current funding algorithm greatly underestimates the resources needed for a guideline-compliant and evidence-based treatment program, even if healthcare providers received 100 % reimbursement of the sum determined by the Psych-PV algorithm. The results clearly show that even in the case of a full coverage of the current German reimbursement algorithm, funding allocation for evidence-based inpatient treatment of chronic depression is insufficient. In addition, the difficulties of specific coding of chronic depression in the ICD-10 system generates a major problem in the attempt to measure the current resources needed for sufficient treatment.