title: [Guideline-oriented inpatient psychiatric psychotherapeutic/psychosomatic treatment of anxiety disorders : How many personnel are need?].
abstract: The reimbursement of inpatient psychiatric psychotherapeutic/psychosomatic hospital treatment in Germany is regulated by the German personnel ordinance for psychiatric hospitals (Psych-PV), which has remained unchanged since 1991. The aim of this article was to estimate the personnel requirements for guideline-adherent psychiatric psychotherapeutic hospital treatment.
  
  
  
  A normative concept for the required psychotherapeutic "dose" for anxiety disorders was determined based on a literature review. The required staffing contingent was compared to the resources provided by the Psych-PV based on category A1.
  
  
  
  According to the German policy guidelines for outpatient psychotherapy, a quota of 25 sessions of 50 min each (as a rule plus 5 probatory sessions) is reimbursed. This approach is supported by studies on dose-response relationships. As patients undergoing inpatient treatment for anxiety disorders are usually more severely ill than outpatients, a contingent of 30 sessions for the average treatment duration of 5 weeks seems appropriate in order to fully exploit the costly inpatient treatment time (300 min per patient and week). In contrast, only 70 min are reimbursed according to the Psych-PV. The total personnel requirement for the normative concept is 624 min per patient and week. The Psych-PV only covers 488 min (78 %).
  
  
  
  Currently, the time contingents for evidence-based psychiatric psychotherapeutic/psychosomatic hospital care are nowhere near sufficient. In the development of future reimbursement systems this needs to be corrected.
authors.affiliation: Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universitätsmedizin Göttingen, 37099, Göttingen, Deutschland. Sekretariat.Bandelow@med.uni-goettingen.de.
authors.forename: B
authors.initials: B
authors.lastname: Bandelow
authors.affiliation: Klinik und Poliklinik für Psychiatrie, Psychosomatik und Psychotherapie, Universitätsklinikum Würzburg, Würzburg, Deutschland.
authors.forename: U
authors.initials: U
authors.lastname: Lueken
authors.affiliation: Abteilung für Betriebswirtschaft und Controlling, Universitätsklinikum Freiburg, Freiburg, Deutschland.|Klinik für Psychiatrie und Psychotherapie, Universitätsklinikum Freiburg, Freiburg, Deutschland.
authors.forename: J
authors.initials: J
authors.lastname: Wolff
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 und Poliklinik für Psychiatrie und Psychotherapie, Universitätsmedizin Göttingen, 37099, Göttingen, Deutschland.|Alexianer Aachen GmbH, Alexianer Krankenhaus Aachen, Aachen, Deutschland.
authors.forename: C
authors.initials: C
authors.lastname: Wolff-Menzler
authors.affiliation: Klinik und Poliklinik für Psychiatrie, Psychosomatik und Psychotherapie, Universitätsklinikum Würzburg, Würzburg, Deutschland.
authors.forename: J
authors.initials: J
authors.lastname: Deckert
authors.affiliation: Klinik und Poliklinik für Psychiatrie und Psychotherapie, Charité - Universitätsmedizin Berlin, Berlin, Deutschland.
authors.forename: A
authors.initials: A
authors.lastname: Ströhle
authors.affiliation: Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Universitätsmedizin Mainz, Mainz, Deutschland.
authors.forename: M
authors.initials: M
authors.lastname: Beutel
authors.affiliation: Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Universitätsmedizin Mainz, Mainz, Deutschland.
authors.forename: J
authors.initials: J
authors.lastname: Wiltink
authors.affiliation: Klinik und Poliklinik für Psychiatrie, Psychosomatik und Psychotherapie, Universitätsklinikum Würzburg, Würzburg, Deutschland.
authors.forename: K
authors.initials: K
authors.lastname: Domschke
authors.affiliation: Klinik für Psychiatrie und Psychotherapie, Universitätsklinikum Freiburg, Freiburg, Deutschland.
authors.forename: M
authors.initials: M
authors.lastname: Berger
mesh_terms: D000328:Adult; D000368:Aged; D001008:Anxiety Disorders / Q000191:economics / Q000453:epidemiology / Q000628:therapy*; 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; D014600:Utilization Review; D000078329:Workforce; D055815:Young Adult
keywords: Anxiety disorders; Guidelines; Inpatients; Psychiatry Personnel Act; Psychotherapy