Psychiatrische Praxis
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Psychiatrische Praxis · Nov 2002
[Institutionalisation-index--a simple method to estimate direct treatment costs for institutionalised forms of community mental health care].
Investigations of treatment costs are of increasing importance in community mental health care. Yet, they are often difficult and expensive to conduct. This study explores whether and, if so, to what extent direct treatment costs as paid by insurance companies and social welfare in the German health care system can be estimated through a simple Institutionalisation-Index. ⋯ The Institutionalisation-Index provides a sufficiently precise estimate of direct costs as paid by insurance companies and social welfare for different forms of care in community based institutions and hospitals. The II can be adjusted to incorporate further forms of community based care. In systems with similar funding arrangements, the simple method to establish a Institutionalisation-Index should facilitate cost analyses in community mental health care.
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Differences in the intensity of social psychiatric care for mentally ill people are examined in two communal socio-psychiatric services in Saxony. Service users are subdivided into three groups according to intensity of service use (low utilization, average utilization and high utilization). ⋯ Standardized documentation is a good basis for the description of different patterns of service utilization, but more information is needed about service users, e.g. data on their health care needs.
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Psychiatrische Praxis · Nov 2001
[Psychiatric care in Sachsen-Anhalt: a survey of institutions and services with the "European Services Mapping Schedule" ESMS].
To describe the availability of outpatient, inpatient and community based psychiatric care in 21 rural districts and 3 cities of Sachsen-Anhalt, one of the federal states of eastern Germany, with rapid changes and developments in psychiatric care over the last ten years. ⋯ Psychiatric care in Germany is fragmentary, as regards providers and funding. Information collected by the "Committee for Issues of Psychiatric Care in Sachsen-Anhalt", taken mainly from visitation protocols, was sufficient to establish a general survey over 24 regions of this federal state. We propose to repeat this approach regularly to monitor developments in the field of social psychiatry for further planning and interventions. Overall, our results show that the aims formulated in the German "Inquiry into Psychiatry" ("Psychiatrie-Enquete") have not been fully accomplished (e.g. the preferential status of outpatient versus in-patient services).
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Suicides in correctional institutions occur more frequently than in the general population. Inmate suicide rates have been increasing in many countries during the last decades, possibly reflecting a selection of highly endangered individuals with a high prevalence of mental disorders. This study investigates all suicides in all correctional institutions of Austria during the last 25 years. ⋯ Obvious signs of suicidality play an important role in vulnerability profiles for jail and prison suicides. Any signs of suicidality (st. p. attempted suicide, verbal suicide threat, self-harm) should have the consequence of further psychiatric care.