M. Huss et al., Day treatment in German child and adolescent psychiatry: A Germany wide analysis with respect to cost-effectiveness, PRAX KINDER, 50(1), 2001, pp. 31-44
Citations number
9
Categorie Soggetti
Psychiatry
Journal title
PRAXIS DER KINDERPSYCHOLOGIE UND KINDERPSYCHIATRIE
Day treatment plays an increasingly important role in German child and adol
escent psychiatry. In spite of a steady and ongoing increase of day treatme
nt facilities over the past 15 years only few empicial data on the structur
e of German day treatment are available. The study refers to an Germany wid
e assessment of all day treatment centers (DTC). 45 out of 61 DTC responded
(reply rate 74%). Analyses were done over 560 treatment places used by 69%
male and 31% female patients mean ages 10 years and 2 months. Mean treatme
nt duration is 104 days without differences with respect to the primary psy
chotherapeutic orientation (behavioral, psychodynamic, family therapy, othe
r). Personnel is in 80,5% of the DTC below the governmental guidelines. Rat
es per day vary between 280 DM and 617 DM with a mean of 389 DM. Mean treat
ment rests per patient are 36.303 DM (min.: 12.825 DM; max.: 89.793 DM). Ra
tes per day and duration of treatment are negatively correlated: The higher
the rate per day, the shorter the treatment (explained variance: 17%). Thi
s correlation can only be explained indirectly by more personnel as associa
ted with higher daily rates. However, more influential is the a mount of ti
me the children are presen t in day treatment per week: The longer the chil
dren are present, the shorter the duration of the whole treatment. Diagnosi
s, gender, and age only influence duration and costs of the treatment margi
nally. Network-effects as operationalized by the availability of additional
inpatient and outpatient facilities did not influence costs and duration o
f day treatment.