title: [How does the Regional Psychiatry Budget (RPB) work in an area with initially low capacity of psychiatric hospital beds?].
abstract: OBJECTIVE
  To analyze the impact of a capitated multi-sector-financing model for psychiatric care (RPB) in the model region Rendsburg-Eckernförde on costs and effectiveness of care.
  
  
  METHODS
  In a prospective controlled cohort study 244 patients with a diagnosis according to ICD-10: F10, F2 or F3 were interviewed in the model region (MR) and compared to 244 patients from a control region (CR) financed according to the fee-for-service principle. At baseline, 1.5 years and 3.5 years follow-up patients were interviewed using measures of psychopathology (CGI-S, HONOS, SCL-90 R/GSI, PANSS, BRMAS/BRMES), functioning (GAF, SOFAS), quality of life (EQ-5 D) and service use/costs (CSSRI).
  
  
  RESULTS
  Subjective symptom severity (GSI) and functioning (GAF) developed more favourably in the MR than in the CR, the HONOS score developed slightly worse in the MR. The latter effect occurred mainly in ICD-10: F10 patients, while patients with F2/3 rather did benefit under RPB conditions. The development of total costs of care was not different between MR and CR. The potential to reduce costs of in-patient care was low due to the initially low capacity of inpatient beds.
  
  
  CONCLUSIONS
  The RPB did not reduce the total costs of mental health care, but certain diagnosis groups may benefit from improved trans-sectoral treatment flexibility.
authors.affiliation: Universitätsklinikum Hamburg-Eppendorf, Institut für Gesundheitsökonomie und Versorgungsforschung, Hamburg Center for Health Economics.
authors.forename: Hans-Helmut
authors.initials: HH
authors.lastname: König
authors.forename: Dirk
authors.initials: D
authors.lastname: Heider
authors.forename: Thomas
authors.initials: T
authors.lastname: Rechlin
authors.forename: Peter
authors.initials: P
authors.lastname: Hoffmann
authors.forename: Thomas
authors.initials: T
authors.lastname: Birker
authors.forename: Sven
authors.initials: S
authors.lastname: Heinrich
authors.forename: Christian
authors.initials: C
authors.lastname: Brettschneider
authors.forename: Cornelia
authors.initials: C
authors.lastname: Hierholzer
authors.forename: Steffi G
authors.initials: SG
authors.lastname: Riedel-Heller
authors.forename: Christiane
authors.initials: C
authors.lastname: Roick
mesh_terms: D000328:Adult; D002017:Budgets / Q000458:organization & administration*; D002204:Capitation Fee / Q000458:organization & administration; D015331:Cohort Studies; D003362:Cost-Benefit Analysis / Q000191:economics; D003695:Delivery of Health Care / Q000191:economics*; D004180:Direct Service Costs; D018588:Fee-for-Service Plans / Q000191:economics; D005260:Female; D005380:Financing, Government / Q000191:economics; D005500:Follow-Up Studies; D005858:Germany; D019981:Health Care Sector / Q000191:economics; D006302:Health Services Research; D006742:Hospital Bed Capacity / Q000191:economics*; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000191:economics* / Q000523:psychology / Q000628:therapy*; D008605:Mental Health Services / Q000191:economics*; D008875:Middle Aged; D009313:National Health Programs / Q000191:economics*; D010043:Outcome and Process Assessment, Health Care; D011446:Prospective Studies; D011567:Psychiatric Department, Hospital / Q000191:economics*; D012040:Regional Health Planning / Q000191:economics*