[The regional budget for mental health care: a new approach to combine inpatient and outpatient care].
OBJECTIVE
Due to increasing health care expenditures the discussion about advantages and disadvantages of new methods for resource allocation in mental health care has been intensified. A promising model is the Regional Budget for Mental Health Care, which is currently being examined in Schleswig-Holstein. The present paper describes first experiences with the new resource allocation model. BASIC CONDITIONS: An annual budget, provided for the treatment of a fixed number of patients, makes it possible to reduce inpatient capacity in favour of improved community-integrated approaches for the treatment of acute psychiatric illness.


RESULTS
In a first step inpatient capacity will be reduced by 8 percent. By the end of 2007 capacity for hospital day care shall be increased by 87 percent and a home treatment will be implemented. The previous working method, orientated to treatment setting, will be replaced by an approach specialized in diagnostic groups.


CONCLUSIONS
The Regional Budget could improve the continuity and flexibility of patient care. Service providers become motivated to treat in a way, which with little resource consumption achieves a long lasting health status improvement. For health insurances the Regional Budget is an opportunity to limit cost increases.
Roick
Christiane
C
Universität Leipzig, Klinik und Poliklinik für Psychiatrie. roich@medizin.uni-leipzig.de
Deister
Arno
A
Zeichner
Dirk
D
Birker
Thomas
T
König
Hans-Helmut
HH
Angermeyer
Matthias C
MC
D000553:Ambulatory Care / Q000191:economics*; D002017:Budgets / Q000706:statistics & numerical data*; D003156:Community Mental Health Services / Q000191:economics*; D017046:Cost Savings / Q000706:statistics & numerical data; D003631:Day Care, Medical / Q000191:economics; D005544:Forecasting; D005858:Germany; D006301:Health Services Needs and Demand / Q000191:economics; D006742:Hospital Bed Capacity / Q000191:economics; D006760:Hospitalization / Q000191:economics*; D006801:Humans; D001523:Mental Disorders / Q000191:economics* / Q000628:therapy; D009313:National Health Programs / Q000191:economics*; D011570:Psychiatry / Q000191:economics*; D012040:Regional Health Planning / Q000191:economics; D012041:Regional Medical Programs / Q000191:economics*; D040841:Resource Allocation / Q000191:economics