[Structures and changes in the combined modality treatment concept at a gerontopsychiatric Europakanal Erlangen Day Care Clinic].
OBJECTIVE
The aim is to describe and analyse the concepts of multimodal clinical work and the impact of changing patient trends on clinical work practices in our Psychogeriatric Day Hospital since it opened in 1986.


METHODS
Day hospital statistics concerning length of stay, referral rates and readmission over the years were analysed. In two evaluation studies, client satisfaction and daily living activities were assessed.


RESULTS
There is firm evidence for the effectiveness of day hospital treatment, as demonstrated by the results of the evaluation studies. In the last two years the average length of day hospital stay reduced significantly, while referrals for day hospital treatment increased rapidly. Despite these changes, the number of staff has stayed the same from 1986 to now.


CONCLUSIONS
For day hospital intervention to remain effective in the light of changing patients trends, adequate time needs to be given for diagnostic and therapeutic procedures including psycho-educational work with patients' family members. This is not only a question of cost-effectiveness, but also an ethical approach bearing in mind future trends towards an increasingly aging population where demand will increase for this type of provision.
D000203:Activities of Daily Living / Q000145:classification; D000368:Aged; D000544:Alzheimer Disease / Q000453:epidemiology / Q000523:psychology / Q000534:rehabilitation*; D015928:Cognitive Behavioral Therapy / Q000639:trends; D003131:Combined Modality Therapy / Q000639:trends; D003631:Day Care, Medical / Q000458:organization & administration / Q000639:trends*; D005260:Female; D005544:Forecasting; D005858:Germany; D006801:Humans; D007902:Length of Stay / Q000639:trends; D008297:Male; D008884:Milieu Therapy / Q000639:trends; D010359:Patient Readmission / Q000639:trends; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D015397:Program Evaluation; D011575:Psychoanalytic Therapy / Q000639:trends; D012017:Referral and Consultation / Q000639:trends