Abstract:
:New models of care aimed at reinforcing the outpatient sector have been introduced in Germany over the last few years. Initially, a subscription-based model ("integrated care") was introduced in 2012 in the Immanuel Klinik Rüdersdorf, wherein patients had to actively subscribe to the integrated care program. This integrated care model was replaced after 2 years by a subscription-free "model project," in which all patients insured by the contracting insurance company took part in the program. Data showed that the introduction of the integrated care program in the inpatient setting led to an increase of the average length of stay in this group. The switch to the model project corrected this unwanted effect but failed in significantly decreasing the average length of stay when compared to standard care. However, both the integrated care program and model project succeeded in reducing the length of stay in the day care setting. When adjusting for the sex and diagnosis proportions of each year, it was shown that diagnosis strongly influenced the average length of stay in both settings, whereas sex only slightly influenced the duration of stay in the inpatient setting. Thus, in spite of strong financial and clinical incentives, the introduction of the model project couldn't fulfill its primary purpose of shifting resources from the inpatient to the outpatient setting in the initial years. Possible explanations, including struggle against long-established traditions and reluctance to change, are discussed.
journal_name
Front Psychiatryjournal_title
Frontiers in psychiatryauthors
Wullschleger A,Wosniok W,Timm J,Heinze Mdoi
10.3389/fpsyt.2017.00196subject
Has Abstractpub_date
2017-10-05 00:00:00pages
196issn
1664-0640journal_volume
8pub_type
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journal_title:Frontiers in psychiatry
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doi:10.3389/fpsyt.2020.00875
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pub_type: 杂志文章
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pub_type: 杂志文章
doi:10.3389/fpsyt.2020.00577
更新日期:2020-06-26 00:00:00
abstract::Introduction: Post-Traumatic Stress Disorder (PTSD) is a prevalent, severe and tenacious psychopathological consequence of traumatic events. Neurobehavioral mechanisms underlying PTSD pathogenesis have been identified, and may serve as risk-resilience factors during the early aftermath of trauma exposure. Longitudinal...
journal_title:Frontiers in psychiatry
pub_type: 杂志文章
doi:10.3389/fpsyt.2018.00477
更新日期:2018-10-04 00:00:00
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pub_type: 杂志文章,评审
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pub_type: 杂志文章
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journal_title:Frontiers in psychiatry
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更新日期:2019-02-27 00:00:00
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journal_title:Frontiers in psychiatry
pub_type: 杂志文章,评审
doi:10.3389/fpsyt.2017.00001
更新日期:2017-01-23 00:00:00
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journal_title:Frontiers in psychiatry
pub_type: 杂志文章
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pub_type: 杂志文章,评审
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doi:10.3389/fpsyt.2017.00124
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