[Day treatment in German child and adolescent psychiatry: analysis of data from a nationwide survey with respect to cost effectiveness].
Day treatment plays an increasingly important role in German child and adolescent psychiatry. In spite of a steady and ongoing increase of day treatment facilities over the past 15 years only few empicial data on the structure of German day treatment are available. The study refers to an Germany wide assessment of all day treatment centers (DTC). 45 out of 61 DTC responded (reply rate 74%). Analyses were done over 560 treatment places used by 69% male and 31% female patients mean ages 10 years and 2 months. Mean treatment duration is 104 days without differences with respect to the primary psychotherapeutic orientation (behavioral, psychodynamic, family therapy, other). Personnel is in 80.5% of the DTC below the governmental guidelines. Rates per day vary between 280 DM and 617 DM with a mean of 389 DM. Mean treatment costs per patient are 36.303 DM (min.: 12.825 DM; max.: 89.793 DM). Rates per day and duration of treatment are negatively correlated: The higher the rate per day, the shorter the treatment (explained variance: 17%). This correlation can only be explained indirectly by more personnel as associated with higher daily rates. However, more influential is the amount of time the children are present in day treatment per week: The longer the children are present, the shorter the duration of the whole treatment. Diagnosis, gender, and age only influence duration and costs of the treatment marginally. Network-effects as operationalized by the availability of additional inpatient and outpatient facilities did not influence costs and duration of day treatment.
Klinik für Psychiatrie, Psychosomatik und Psychotherapie der Kindes- und Jugendalters, Charité Campus Virchow-Klinikum der Humboldt-Universität zu Berlin, Augustenburger Platz 1, 13353 Berlin. michael.huss@charite.de
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D000293:Adolescent; D000328:Adult; D002648:Child; D003362:Cost-Benefit Analysis; D003631:Day Care, Medical / Q000191:economics* / Q000379:methods / Q000639:trends; D005260:Female; D005858:Germany; D006801:Humans; D007902:Length of Stay / Q000191:economics; D008297:Male; D001523:Mental Disorders / Q000191:economics / Q000628:therapy*; D017063:Outcome Assessment, Health Care; D011613:Psychotherapy / Q000191:economics; D012114:Residential Treatment / Q000191:economics* / Q000379:methods