[Evaluation of the effectiveness of psychosomatic in-patient treatment on the basis of subjective and objective criteria].
OBJECTIVE
The effectiveness of psychosomatic in-patient treatment was evaluated using patients' subjective health ratings and objective data provided by health insurance companies. Associations between subjective and objective criteria were investigated.


METHODS
318 patients participated in the study. They completed questionnaires on physical complaints, moods and everyday functioning upon hospital admission, at discharge and at one-year follow-up. Insurance companies provided data for 140 of these patients (44 %). Sick leave and the utilization of in-patient treatment were assessed for a period of two years before and two years after psychosomatic treatment.


RESULTS
As expected, subjective health status improved. The utilization of in-patient treatment decreased in both years after treatment compared to the year before. Sick leave increased in the first year after treatment but decreased significantly below the base level in the second year after treatment. Self-efficacy expectations and being employed were found to be predictors for long-term reduction in the length of in-patient treatment. Subjective and objective criteria were only slightly correlated.


CONCLUSIONS
Sick leave and utilization of in-patient treatment were found to increase considerably in the year before psychosomatic treatment. Therefore, pre-post differences over the entire period were only marginal. The change in subjective criteria was more immediate, while changes in some objective parameters were delayed. Both subjective and objective criteria should be included in outcome studies.
Fliege
Herbert
H
Medizinische Klinik mit Schwerpunkt Psychosomatik, Charité - Universitätsmedizin Berlin. herbert.fliege@charite.de
Rogalinski
Anja
A
Schmid
Gabriele
G
Kocalevent
Rüya-Daniela
RD
Lohmann
Ruediger
R
Danzer
Gerhard
G
Klapp
Burghard F
BF
D000203:Activities of Daily Living / Q000523:psychology; D000293:Adolescent; D000328:Adult; D000339:Affect; D000368:Aged; D003625:Data Collection / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D005858:Germany; D006801:Humans; D007350:Insurance, Hospitalization / Q000706:statistics & numerical data; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D010343:Patient Admission; D010359:Patient Readmission / Q000706:statistics & numerical data; D011602:Psychophysiologic Disorders / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D018582:Sick Leave; D016896:Treatment Outcome