[The work of medical doctors on psychiatric wards: an analysis of everyday activities].
In Germany, the economic situation of psychiatric hospitals has markedly changed during the last years. Whilst the number of patients has steadily increased, many clinics considerably reduced the number of therapeutic staff due to an increasing lack of financial support. The German psychiatry personnel regulations act defines the number of therapeutic staff required for an adequate psychiatric treatment, but the requirements of this regulations act nowadays are widely missed in most of the German psychiatric hospitals. This severely affects the therapeutic work on psychiatric wards. This study analyses tasks and activities of medical doctors on psychiatric wards and compares the hours spent with various types of activities with the amount of time that should be spent according to the personnel regulations act. Results show that doctors spend much more time with documentation and administrative work than originally intended by the personnel regulations act. They compensate this mainly by a reduction of time spent in direct contact with the patients. In this context, the number of psychotherapy sessions as well as sessions with the patients' relatives has been considerably reduced, whereas the time spent for emergency intervention and basic treatment still corresponds to the calculations according to the personnel regulations act. All in all, the results show that a reduction of therapeutic staff in psychiatric hospitals directly leads to a change in treatment settings with a focus on less individual treatment options.
Klinik und Poliklinik für Psychiatrie, Psychosomatik und Psychotherapie der Universität am Bezirksklinikum Regensburg. albert.putzhammer@medbo.de
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A
Putzhammer
I
I
Senft
H
H
Fleischmann
H E
HE
Klein
M
M
Schmauss
W
W
Schreiber
G
G
Hajak
D004282:Documentation / Q000191:economics / Q000706:statistics & numerical data; D005858:Germany; D006301:Health Services Needs and Demand / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D009313:National Health Programs / Q000191:economics* / Q000331:legislation & jurisprudence; D010561:Personnel Staffing and Scheduling / Q000191:economics* / Q000331:legislation & jurisprudence; D010819:Physician's Role; D010817:Physician-Patient Relations; D011567:Psychiatric Department, Hospital / Q000191:economics* / Q000331:legislation & jurisprudence; D011613:Psychotherapy / Q000191:economics; D011785:Quality Assurance, Health Care / Q000191:economics / Q000331:legislation & jurisprudence; D013996:Time and Motion Studies; D000078329:Workforce