[The new payment system in psychiatry - do elderly people belong to the losers? An analysis on the basis of the VIPP1 data base].
The development of the lump-sum reimbursement System in psychiatry and psychosomatics (PEPP) (Klimke et al., 2014) is being negatively considered - also in gerontopsychiatry.Thus it is reasonable to make a timely analysis of the effects of PEPP on health-care structures. For this two analyses have been carried out. On the one hand the day mix index of elderly patients (> 64 years) was compared with that of younger ones (> 17 years, < 65 years). On the other hand younger and older were included in the analysis with regard to the available treatment minutes in exact daily classifications according to the PsychPV. It is seen that evaluation of the individual day was markedly higher for gerontopsychiatric patients not only in inpatient (difference > 0.1) but also in outpatient (difference > 0.07) setting. The exact daily classifications according to PsychPV, however, were markedly poorer for the elderly patients. Thus, on the basis of routine data of VIPP projects, a clear change can be seen in favour of the elderly patient under PEPP conditions as compared to financing according to PsychPV. However, concern remains that the ageing population and modernisation of therapy are not being sufficiently taken into account. The new reimbursement system merely regulates the distribution of available resources; if these resources are too low nothing will change by the PEPP-System.
Klinik für Psychiatrie und Psychotherapie, St. Joseph-Krankenhaus Berlin-Weißensee, Berlin.
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Godemann
Psychiatrie, Fachhochschule für Diakonie, Bielefeld.
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Löhr
Klinik für Psychiatrie, Psychotherapie und Psychosomatik, Alexianer St. Joseph-Krankenhaus, Berlin.
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Wiegand
Klinik für Psychiatrie und Psychotherapie, Universitätsmedizin Göttingen.
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Wolff-Menzler
Medizincontrolling, Zentralinstitut für Seelische Gesundheit, Mannheim.
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Nitschke
Fachklinik für Psychiatrie, Psychotherapie und Psychosomatik, kbo-Lech-Mangfall-Klinik, Garmisch-Partenkirchen.
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Seemüller
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged / Q000523:psychology*; D000369:Aged, 80 and over; D016208:Databases, Factual; D003953:Diagnosis-Related Groups; D005260:Female; D005858:Germany; D006295:Health Resources; D006801:Humans; D007349:Insurance, Health, Reimbursement / Q000191:economics*; D008297:Male; D008875:Middle Aged; D011153:Population; D011570:Psychiatry / Q000191:economics*; D011611:Psychosomatic Medicine / Q000191:economics*; D055815:Young Adult