title: [Admission and discharge decisions in psychiatric hospitals : The 7-day cycle: analysis based on the VIPP database].
abstract: BACKGROUND
  The legislation requires all scientific societies in the field of inpatient psychiatric and psychosomatic healthcare to survey and assess the effects and financial incentives of the new flat rate day-based remuneration system in psychiatric and psychosomatic facilities (PEPP system). As day-based remuneration systems may be an incentive to extend treatment, it is necessary to measure and analyze the future development of the number of cases and the duration of treatment.
  
  
  OBJECTIVE
  This article surveys admission and discharge decisions of psychiatric and psychosomatic facilities. The distribution of admissions and discharges throughout the days of the week were analyzed to search for evidence of a systematic extension of treatment over the weekend.
  
  
  METHODS
  The analysis is based on data from the Versorgungsrelevante Indikatoren in der Psychiatrie und Psychosomatik (VIPP, treatment-relevant indicators in psychiatry and psychosomatics) project database, which contains routine data from psychiatric and psychosomatic facilities. On this basis the distributions of admissions and discharges throughout the days of the week were analyzed on aggregate and diagnosis-specific levels.
  
  
  RESULTS
  Patients were mostly admitted to hospitals within the first 3 weekdays. The discharge mostly took place on Fridays and not as a financial incentive on Mondays. Regarding the patient length of stay a 7-day cycle can be observed, which may indicate the importance of medical and organizational factors in discharge decisions.
  
  
  CONCLUSIONS
  The results do not show evidence for a systematic extension of treatment over the weekend. Over the next years it will be important to observe the development of the duration of treatment and the number of cases to assess the influence of the economic incentives of the PEPP system on the utilization of psychiatric and psychosomatic healthcare.
authors.affiliation: Abt. Allgemeinpsychiatrie, Alexianer Fachkrankenhaus Aachen, Aachen, Deutschland. cwolff@gwdg.de.|Klinik für Psychiatrie und Psychotherapie, Universitätsmedizin Göttingen, Von-Siebold-Str. 5, 37075, Göttingen, Deutschland. cwolff@gwdg.de.
authors.forename: C
authors.initials: C
authors.lastname: Wolff-Menzler
authors.affiliation: GSG Consulting GmbH, Dortmund, Deutschland.
authors.forename: S
authors.initials: S
authors.lastname: Gyßer
authors.affiliation: Finanzen und Controlling, Georg-August-Universität Göttingen, Göttingen, Deutschland.
authors.forename: C
authors.initials: C
authors.lastname: Große
authors.affiliation: Klinik für Allgemeine Psychiatrie, Universitätsklinikum Heidelberg, Heidelberg, Deutschland.
authors.forename: S
authors.initials: S
authors.lastname: Häfner
authors.affiliation: Garmisch-Partenkirchen Zentralinstitut für Seelische Gesundheit, KBO-Lech-Mangfall-Kliniken, Garmisch-Partenkirchen, Deutschland.
authors.forename: F
authors.initials: F
authors.lastname: Seemüller
authors.affiliation: Klinik für Seelische Gesundheit im Alter und Verhaltensmedizin, Alexianer St. Joseph Krankenhaus, Berlin-Weißensee, Deutschland.
authors.forename: F
authors.initials: F
authors.lastname: Godemann
authors.affiliation: Klinik für Seelische Gesundheit im Alter und Verhaltensmedizin, Alexianer St. Joseph Krankenhaus, Berlin-Weißensee, Deutschland.
authors.forename: H
authors.initials: H
authors.lastname: Wiegand
authors.affiliation: Fachhochschule der Diakonie in Bielefeld, Bielefeld, Deutschland.
authors.forename: M
authors.initials: M
authors.lastname: Löhr
mesh_terms: D000066491:Clinical Decision-Making; D016208:Databases, Factual; D005858:Germany / Q000453:epidemiology; D006778:Hospitals, Psychiatric / Q000706:statistics & numerical data*; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data*; D010343:Patient Admission / Q000706:statistics & numerical data*; D010351:Patient Discharge / Q000706:statistics & numerical data*; D014600:Utilization Review; D016526:Workload / Q000706:statistics & numerical data*
keywords: Case and discharge management; Incentives; PEPP system; Psychiatric and psychosomatic facilities; Remuneration system