[A patient flow analysis within the Munich addiction treatment system--a pilot study].
BACKGROUND
The highest efficiency in addiction treatment is attributed to a multistage programme consisting of several intervention types (e. g., counselling, withdrawal, therapy, community adjustment) in a specific order.


OBJECTIVE
The pilot study described focuses on the interactions between treatment modalities (i. e. on the process quality) within the addiction treatment system in Munich and the broader environs.


METHODS
In eleven institutions out of the several intervention types 452 persons were anonymously queried. The interview was conducted by means of a questionnaire, which gathered information about the sequence of interventions.


RESULTS
The results suggest that the treatment sequences (i. e. the patient flow) investigated are consistent with the intended cooperation within the multistage treatment programme. Furthermore, the results also indicate that more than a quarter of the participants came sought treatment/counselling of their own initiative. Particularly interesting is the observation that the participating institutions rarely checked where "their" patients pursue aftercare/treatment follow-up upon completion of the prescribed programme. Regarding the actual referrals during the four week investigation period, relatively low referrals among the participants in the drop-in center were observed. CRITICISM: It remains doubtful whether the selected institutions are really representative of the different intervention types, because the participating institutions within an intervention type operate from diverse conceptual backgrounds. Furthermore, the sample size obtained was both small and contained a diverse number of participants per institution type. Therefore, whether or not the results can be generalized is questionable.


CONCLUSIONS
Based on these results the BAS supports the deployment and legal establishment of case managers in the coordination of a patient's global treatment process. It is believed that this step would result in a more purposeful and economical treatment within the multistage addiction treatment programme.
Queri
S
S
Bayerische Akademie für Suchtfragen in Forschung und Praxis BAS e. V., München. queri@bas-muenchen.de
Servaty
M
M
Eckstein
G
G
Tretter
F
F
D000293:Adolescent; D000328:Adult; D019090:Case Management / Q000706:statistics & numerical data*; D019033:Delivery of Health Care, Integrated / Q000706:statistics & numerical data*; D017598:Efficiency, Organizational; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010348:Patient Care Team / Q000706:statistics & numerical data*; D011787:Quality of Health Care / Q000706:statistics & numerical data*; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D019966:Substance-Related Disorders / Q000628:therapy*; D014600:Utilization Review