title: [Guideline-conform psychiatric psychotherapeutic treatment for patients with schizophrenia : A normative evaluation of necessary personnel requirements].
abstract: BACKGROUND
  Although national treatment guidelines and current publications of the German Federal Joint Committee (Gemeinsamer Bundesausschuss) recommend cognitive behavior therapy for all patients with schizophrenia, the implementation of these recommendations in current inpatient and outpatient treatment is only rudimentary.
  
  
  OBJECTIVE
  The aim of this study was to systematically search randomized controlled studies (RCTs), meta-analyses and the guidelines of the German Association for Psychiatry and Psychotherapy, Psychosomatics and Neurology (DGPPN) and the British National Institute for Health and Clinical Excellence (NICE) in order to assess the number of personnel necessary for psychiatric and therapeutic inpatient treatment in line with present guidelines. Moreover, the number of staff required was compared with the personnel resources designated by the German psychiatry personnel regulations (Psych-PV).
  
  
  METHODS
  The German and NICE guidelines, RCTs and meta-analyses were analyzed and an adequate weekly treatment plan for an inpatient unit was developed. Moreover, the number of personnel necessary to realize the treatment plan was calculated.
  
  
  RESULTS
  In order to realize adequate inpatient treatment approximately 107 min extra for medical psychotherapeutic personnel per patient and week (of which 72 min for psychotherapy) and another 60 min for nursing staff per patient and week are required in addition to the current Psych-PV regulations. Thus, implementation in an open ward with 20 inpatients would require 3.62 positions for physicians, 0.7 positions in psychology and 12.85 positions for nursing staff (including management positions and night shifts).
  
  
  CONCLUSIONS
  These evidence-based recommendations for precise specifications of inpatient treatment should lead to improved inpatient treatment in line with present guidelines. Moreover, outpatients and day patients could be included in this treatment model. The results should be considered in the construction of the future prospective payment system for inpatient psychiatric healthcare in Germany.
authors.affiliation: Klinik für Psychiatrie und Psychotherapie, Universitätsklinikum Marburg, Philipps-Universität Marburg, Rudolf-Bultmann-Str. 8, 35039, Marburg, Deutschland. Stephanie.mehl@med.uni-marburg.de.
authors.forename: S
authors.initials: S
authors.lastname: Mehl
authors.affiliation: Klinik für Psychiatrie und Psychotherapie, Klinikum der Universität München, Ludwig-Maximilians Universität München, München, Deutschland.
authors.forename: P
authors.initials: P
authors.lastname: Falkai
authors.affiliation: Klinik für Psychiatrie und Psychotherapie, Universitätsklinikum Freiburg, Albert-Ludwigs-Universität Freiburg, Freiburg, Deutschland.
authors.forename: M
authors.initials: M
authors.lastname: Berger
authors.affiliation: Fachhochschule der Diakonie, Bielefeld, Deutschland.|Klinik für Psychiatrie, Psychotherapie und Psychosomatik, Universitätsklinikum Halle, Martin-Luther-Universität Halle, Halle, Deutschland.
authors.forename: M
authors.initials: M
authors.lastname: Löhr
authors.affiliation: Klinik für Psychiatrie, Psychotherapie und Psychosomatik, Universitätsklinikum Halle, Martin-Luther-Universität Halle, Halle, Deutschland.
authors.forename: D
authors.initials: D
authors.lastname: Rujescu
authors.affiliation: Abteilung für Betriebswirtschaft und Controlling, Universitätsklinikum Freiburg, Freiburg, Deutschland.|Institute of Psychiatry, Psychology and Neuroscience, Centre for the Economics of Mental and Physical Health, King's College, London, UK.
authors.forename: J
authors.initials: J
authors.lastname: Wolff
authors.affiliation: Klinik für Psychiatrie und Psychotherapie, Universitätsklinikum Marburg, Philipps-Universität Marburg, Rudolf-Bultmann-Str. 8, 35039, Marburg, Deutschland.
authors.forename: T
authors.initials: T
authors.lastname: Kircher
mesh_terms: D000328:Adult; D000368:Aged; D002908:Chronic Disease; D002983:Clinical Competence / Q000191:economics / Q000592:standards; D005858:Germany / Q000453:epidemiology; D019983:Guideline Adherence / Q000191:economics / Q000592:standards / Q000706:statistics & numerical data; D006778:Hospitals, Psychiatric / Q000191:economics / Q000592:standards* / Q000706:statistics & numerical data*; D006801:Humans; D008875:Middle Aged; D020380:Needs Assessment / Q000191:economics; D010561:Personnel Staffing and Scheduling / Q000191:economics / Q000706:statistics & numerical data*; D017410:Practice Guidelines as Topic; D015995:Prevalence; D011570:Psychiatry / Q000191:economics / Q000592:standards / Q000706:statistics & numerical data; D011613:Psychotherapy / Q000191:economics / Q000592:standards* / Q000706:statistics & numerical data; D012559:Schizophrenia / Q000191:economics / Q000628:therapy*; D012565:Schizophrenic Psychology; D014600:Utilization Review; D000078329:Workforce; D055815:Young Adult
keywords: Cognitive behavior therapy; Evidence based practice; Guidelines; Inpatient; Schizophrenia
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