title: [Resource use and financing of guideline-adherent psychotherapeutic inpatient care].
abstract: BACKGROUND
  The financing of psychiatric psychotherapeutic care in Germany is determined by the German psychiatric staffing regulations which are unchanged since 1991. Psychotherapy was established after 1991 as an effective and indispensable treatment of mental and behavioral disorders.
  
  
  OBJECTIVE
  The aim of this study was to empirically investigate the use of psychiatrists' and psychologists' working time for psychotherapy in guideline-adherent hospital care. A further aim was to compare these results to the resources defined by the German psychiatric staffing regulations and in the new prospective payment system for psychiatry and psychosomatics in Germany.
  
  
  METHODS
  University hospitals for psychiatry and psychotherapy were asked to retrospectively provide data of patients for which guideline-adherent care was possible. Participating institutions provided both data describing the staff time utilization of psychotherapeutic services provided by psychiatrists and psychologists and patient classifications according to the German psychiatric staffing regulations and the new prospective payment system for psychiatry and psychosomatics.
  
  
  RESULTS
  Resources defined by the German psychiatric staffing regulations covered a mean of only 71 min of psychotherapy per patient and week while the actual mean intensity of psychotherapeutic care provided by the participating hospitals was 194 min per patient and week. The associated use of staff time was 102 min per patient and week. Both figures increased during an inpatient episode. The resources defined by the German psychiatric staffing regulations covered only 70 % of medical and psychological personnel. The current configuration of the new prospective payment system for psychiatry and psychosomatics covered only 59 % of staff time.
  
  
  CONCLUSIONS
  The results of this study provide another unambiguous recommendation to adjust the out-dated German psychiatric staffing regulations to the current evidence and S3 guidelines for psychiatric psychotherapeutic hospital care. In particular, more resources are required for the provision of psychotherapeutic care.
authors: Klinik für Psychiatrie und Psychotherapie, Universitätsklinikum Freiburg, Hauptstr. 5, 79104, Freiburg, Deutschland, claus.normann@uniklinik-freiburg.de.
authors: C
authors: C
authors: Normann
authors: J
authors: J
authors: Wolff
authors: A
authors: A
authors: Hochlehnert
authors: J P
authors: JP
authors: Klein
authors: F
authors: F
authors: Hohagen
authors: K
authors: K
authors: Lieb
authors: J
authors: J
authors: Deckert
authors: P
authors: P
authors: Falkai
authors: M
authors: M
authors: Berger
authors: S C
authors: SC
authors: Herpertz
mesh_terms: D005380:Financing, Government / Q000191:economics* / Q000592:standards; D005858:Germany; D019983:Guideline Adherence / Q000191:economics / Q000592:standards; D015276:Health Care Rationing / Q000191:economics* / Q000592:standards; D006778:Hospitals, Psychiatric / Q000191:economics* / Q000592:standards; D006801:Humans; D001523:Mental Disorders / Q000191:economics* / Q000628:therapy*; D017410:Practice Guidelines as Topic; D011613:Psychotherapy / Q000706:statistics & numerical data*; D014600:Utilization Review