title: [Normative-empirical determination of personnel requirements in psychosomatic medicine and psychotherapy].
abstract: OBJECTIVE
  There is a high degree of misallocated medical care for patients with somatoform disorders and patients with concomitant mental diseases. This complex of problems could be reduced remarkably by integrating psychosomatic departments into hospitals with maximum medical care. Admitting a few big psychosomatic specialist clinics into the calculation basis decreased the Day-Mix Index (DMI). The massive reduction of the calculated costs per day leads to a gap in funding resulting in a loss of the necessary personnel requirements - at least in university psychosomatic departments. The objective of this article is therefore to empirically verify the reference numbers of personnel resources calculated on the basis of the new German lump-sum reimbursement system in psychiatry and psychosomatics (PEPP).
  
  
  METHODS
  The minute values of the reference numbers of Heuft (1999) are contrasted with the minute values of the PEPP reimbursement system in the years 2013 and 2014, as calculated by the Institute for Payment Systems in Hospitals (InEK).
  
  
  RESULTS
  The minute values derived from the PEPP data show a remarkable convergence with the minute values of Heuft's reference numbers (1999).
  
  
  CONCLUSIONS
  A pure pricing system like the PEPP reimbursement system as designed so far threatens empirically verifiable and qualified personnel requirements of psychosomatic departments. In order to ensure the necessary therapy dosage and display it in minute values according to the valid OPS procedure codes, the minimum limit of the reference numbers is mandatory to maintain the substance of psychosomatic care. Based on the present calculation, a base rate of at least 285 e has to be politically demanded. Future developments in personnel costs have to be refinanced at 100 %.
authors.affiliation: Klinik für Psychosomatik und Psychotherapie, Universitätsklinikum Münster, Domagkstraße 20, 48149 Münster.
authors.forename: Gereon
authors.initials: G
authors.lastname: Heuft
authors.affiliation: Geteilte Erstautorenschaft.|Klinik für Allgemeine Innere Medizin und Psychosomatik der Universität Heidelberg.
authors.forename: Achim
authors.initials: A
authors.lastname: Hochlehnert
authors.affiliation: Koordinierungsstelle der Universitätsklinika BW, Universitätsklinikum Heidelberg.
authors.forename: Steffi
authors.initials: S
authors.lastname: Barufka
authors.affiliation: Klinik für Allgemeine Innere Medizin und Psychosomatik der Universität Heidelberg.
authors.forename: Christoph
authors.initials: C
authors.lastname: Nikendei
authors.affiliation: Klinik für Psychosomatische Medizin und Psychotherapie, Universitätsklinikum Gießen und Marburg.
authors.forename: Johannes
authors.initials: J
authors.lastname: Kruse
authors.affiliation: Innere Medizin VI - Abt. für Psychosomatische Medizin und Psychotherapie der Universität Tübingen.
authors.forename: Stephan
authors.initials: S
authors.lastname: Zipfel
authors.affiliation: Medizinische Klinik mit Schwerpunkt Psychosomatik, Centrum für Innere Medizin und Dermatologie, Charité - Universitätsmedizin Berlin.
authors.forename: Tobias
authors.initials: T
authors.lastname: Hofmann
authors.affiliation: Klinik für Psychosomatische Medizin und Psychotherapie, Lüdenscheid.
authors.forename: Gerhard
authors.initials: G
authors.lastname: Hildenbrand
authors.affiliation: Schön-Klinik Roseneck, Prien am Chiemsee.
authors.forename: Ulrich
authors.initials: U
authors.lastname: Cuntz
authors.affiliation: Klinik für Psychosomatik und Psychotherapie, Universitätsklinikum Münster.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Herzog
authors.affiliation: Klinik für Allgemeine Innere Medizin und Psychosomatik der Universität Heidelberg.
authors.forename: Michael
authors.initials: M
authors.lastname: Heller
mesh_terms: D015897:Comorbidity; D017046:Cost Savings / Q000191:economics; D003430:Cross-Sectional Studies; D019033:Delivery of Health Care, Integrated; D036262:Empirical Research; D005858:Germany; D015276:Health Care Rationing / Q000191:economics; D006301:Health Services Needs and Demand / Q000191:economics*; D006801:Humans; D001523:Mental Disorders / Q000191:economics* / Q000453:epidemiology / Q000628:therapy*; D018803:Models, Economic; D011445:Prospective Payment System / Q000191:economics; D011570:Psychiatry / Q000191:economics*; D011602:Psychophysiologic Disorders / Q000191:economics* / Q000453:epidemiology / Q000628:therapy*; D011611:Psychosomatic Medicine / Q000191:economics*; D011613:Psychotherapy / Q000191:economics*; D015895:Relative Value Scales; D000078329:Workforce
keywords: Economic Analysis; Germany; National Lump-Sum Reimbursement System in Psychosomatic Medicine; Personnel Requirements