[Statutory duties of German psychiatric outpatient clinics and their real care conditions].
OBJECTIVE
This study examines whether psychiatric outpatient clinics fulfill their statutory role of providing psychiatric services for patients with severe mental disorders.


METHODS
A retrospective cross-sectional study on 1,672 patients of a psychiatric outpatient clinic for the year 2010, based on 30 variables. Associations between variables were explored by means of robust multivariate regression models and polynomial regression plots.


RESULTS
The patients' average CGI value was found to be 5.98, the mean GAF-score 47.3, and the mean duration of illness 13.8 years. A third of the sample attempted suicide in the past. Metabolic comorbidity was found in 23.1 % of the sample. Results of regression analyses reveal positive effects of the disease severity and functional impairment on the use of psychiatric care. Patients with affective and schizophrenic disorders received more units of care and caused more costs. Patients living in nursing homes received less in- and outpatient care but caused more medication costs.


CONCLUSIONS
Study results support the assumption that German psychiatric outpatient clinics fulfill their statutory duties by treating severely chronically mentally ill patients. The patients' use of care is positively related to the disease severity and their functional impairment. However, results of the regression analyses suggest that patients living in nursing homes received less psychiatric care than patients who live more independently.
Zentrum für Psychiatrie Südwürttemberg, Universität zu Ulm I. juan.valdes-stauber@zfpzentrum.de
Juan
J
Valdes-Stauber
Reinhold
R
Kilian
D000328:Adult; D000368:Aged; D002908:Chronic Disease; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003865:Major Depressive Disorder / Q000191:economics / Q000628:therapy*; D004185:Disability Evaluation; D005260:Female; D005858:Germany; D006778:Hospitals, Psychiatric / Q000191:economics / Q000592:standards*; D006801:Humans; D007902:Length of Stay / Q000191:economics; D008297:Male; D008875:Middle Aged; D009313:National Health Programs / Q000191:economics / Q000592:standards*; D010044:Outpatient Clinics, Hospital / Q000191:economics / Q000592:standards*; D011785:Quality Assurance, Health Care / Q000191:economics / Q000592:standards*; D012189:Retrospective Studies; D012423:Rural Health / Q000191:economics / Q000592:standards*; D012559:Schizophrenia / Q000191:economics / Q000628:therapy*