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Article: Health-related quality of life among patients with treated alcohol use disorders, schizophreniform disorders or affective disorders and the influence of flexible and integrative psychiatric care models in Germany (PsychCare).

Neumann, Anne / Soltmann, Bettina / Kliemt, Roman / Weinhold, Ines / Schmitt, Jochen / Pfennig, Andrea / Baum, Fabian

2023 Volume 14, Page(s) 1068087

Abstract: Introduction: Flexible and integrated treatment options (FIT) have been established in German psychiatric hospitals to enhance continuous and patient-centered treatment for patients with mental disorders. We hypothesized that patients with experience in ...

Abstract	Introduction: Flexible and integrated treatment options (FIT) have been established in German psychiatric hospitals to enhance continuous and patient-centered treatment for patients with mental disorders. We hypothesized that patients with experience in FIT treatment showed higher health-related quality of life (HRQoL) and comparable symptom severity compared with patients treated as usual (TAU). Further, we expected that some sub-dimensions of HRQoL determined HRQoL results clearer than others, while certain factors influenced HRQoL and symptom severity stronger in the FIT compared to the TAU group. In addition, we hypothesized that HRQoL is correlated with symptom severity. Methods: We undertook a controlled, prospective, multicenter cohort study (PsychCare) conducted in 18 psychiatric hospitals in Germany, using the questionnaires Quality of Well Being Self-Administered (QWB-SA) (HRQoL) and Symptom-Checklist-K-9 (SCL-K-9) (symptom severity) at recruitment (measurement I) and 15 months later (measurement II). We assessed overall HRQoL (measured in health utility weights (HUW) and symptom severity score for patients from FIT and TAU treatment. We investigated the QWB-SA dimensions and separated the results by diagnosis. We used beta regressions to estimate the effect of multiple co-variates on both outcomes. To investigate the correlation between HRQoL and symptom severity, we used Pearson correlation. Results: During measurement I, 1,150 patients were recruited; while 359 patients participated during measurement II. FIT patients reported higher HUWs at measurement I compared to TAU patients (0.530 vs. 0.481, Discussion: Health-related quality of life (during hospital treatment) was higher among patients treated in FIT hospitals compared to patients in routine care, while symptom severity was comparable between both groups.
Language	English
Publishing date	2023-03-31
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2564218-2
ISSN	1664-0640
ISSN	1664-0640
DOI	10.3389/fpsyt.2023.1068087
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Changes in patient care through flexible and integrated treatment programs in German psychiatric hospitals: meta-analyses based on a series of controlled claims-based cohort studies.

Neumann, Anne / Schmitt, Jochen / Seifert, Martin / Kliemt, Roman / March, Stefanie / Häckl, Dennis / Swart, Enno / Pfennig, Andrea / Baum, Fabian

BMC psychiatry

2024 Volume 24, Issue 1, Page(s) 74

Abstract: Background: Global treatment budgets, i.e. predefined budgets for patients treated in hospital independent of the setting within the hospital, together with flexible and integrated treatment (FIT) have been introduced in some German psychiatric ... ...

Abstract	Background: Global treatment budgets, i.e. predefined budgets for patients treated in hospital independent of the setting within the hospital, together with flexible and integrated treatment (FIT) have been introduced in some German psychiatric hospitals since 2013. We investigated pooled changes in inpatient, day-care, outpatient treatment, and continuity of care for patients with mental disorders in 12 FIT-hospitals. Methods: We conducted a series of 12 controlled cohort studies regarding FIT hospitals using anonymized patient claims data from more than 70 German statutory health insurance funds. Each study compared one FIT-hospital to matched patients from equivalent non-FIT-hospitals (routine care). We included only those patients without treatment in the respective hospital within two years prior to first hospital treatment (either FIT or routine care). We contrasted results between the year prior to with the first and second year after patient's first treatment (treatment continuity: only group comparison) using multivariate multi-level models. To approximate the difference-in-difference effect in the meta-analysis, we used the interaction terms group (FIT hospital vs. routine care) x time (year before vs. first or second patient year after study inclusion) in the Poisson models. Results: The 12 studies included 36,069 patients with 2,358 patients from a Department of child and adolescent psychiatry. The pooled effect revealed a 5.1 days lower increase in inpatient treatment in FIT-hospitals during the first patient year compared to routine care. Results were statistically significant for adult care FIT-hospitals but not for child and adolescent FIT-hospitals. Utilization of day-care treatment increased more in most FIT-hospitals during the first year, while outpatient contacts increased in some and decreased in others. The odds of treatment continuity increased by 1.4 in FIT-hospitals compared to non-FIT-hospitals. Conclusions: Global treatment budgets lead to the intended changes in mental health care in the majority of FIT-hospitals compared to routine care in this large real-world evidence study from Germany. For child and adolescent psychiatry, more evidence is needed to draw firm conclusions. Trial registration: This study was registered in the database "Health Services Research Germany" (trial number: VVfD_EVA64_15_003713).
MeSH term(s)	Adult ; Adolescent ; Child ; Humans ; Hospitals, Psychiatric ; Cohort Studies ; Hospitalization ; Mental Disorders/therapy ; Ambulatory Care ; Germany
Language	English
Publishing date	2024-01-26
Publishing country	England
Document type	Meta-Analysis ; Journal Article
ZDB-ID	2050438-X
ISSN	1471-244X ; 1471-244X
ISSN (online)	1471-244X
ISSN	1471-244X
DOI	10.1186/s12888-024-05500-0
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Article ; Online: [No title information]

Neumann, Anne / Kliemt, Roman / Baum, Fabian / Seifert, Martin / Kubat, Denise / March, Stefanie / Weinhold, Ines / Swart, Enno / Schmitt, Jochen

Gesundheitswesen (Bundesverband der Arzte des Offentlichen Gesundheitsdienstes (Germany))

2024

Title translation	Evaluation von neuen Versorgungsformen für Menschen mit psychischen Erkrankungen: Pro & Contra zum Einsatz von GKV-Routinedaten – Ein Erfahrungsbericht.
Language	German
Publishing date	2024-04-02
Publishing country	Germany
Document type	Journal Article
ZDB-ID	1101426-x
ISSN	1439-4421 ; 0941-3790 ; 0949-7013
ISSN (online)	1439-4421
ISSN	0941-3790 ; 0949-7013
DOI	10.1055/a-2297-5347
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Book ; Thesis: Simulations with the PANDA Micro-Vertex-Detector

Kliemt, Ralf

2013

Author's details	von Ralf Kliemt
Language	English
Size	94 S., Ill., graph. Darst.
Document type	Book ; Thesis
Thesis / German Habilitation thesis	Univ., Diss.--Bonn, 2013
Database	Library catalogue of the German National Library of Science and Technology (TIB), Hannover

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Article: Evaluation von neuen Versorgungsformen für Menschen mit psychischen Erkrankungen: Pro & Contra zum Einsatz von GKV-Routinedaten – Ein Erfahrungsbericht

Neumann, Anne / Kliemt, Roman / Baum, Fabian / Seifert, Martin / Kubat, Denise / March, Stefanie / Weinhold, Ines / Swart, Enno / Schmitt, Jochen

Das Gesundheitswesen

2024

Abstract: Der vorliegende Artikel stellt die Besonderheiten in der Evaluation von Versorgungsformen bei Menschen mit psychischen Erkrankungen in Deutschland dar. Es werden die Erfahrungen der Evaluation von Modellvorhaben in der psychiatrischen ... ...

Abstract	Der vorliegende Artikel stellt die Besonderheiten in der Evaluation von Versorgungsformen bei Menschen mit psychischen Erkrankungen in Deutschland dar. Es werden die Erfahrungen der Evaluation von Modellvorhaben in der psychiatrischen Versorgungsforschung basierend auf Routinedaten gesetzlicher Krankenversicherungen (GKV) von über 70 gesetzlichen Krankenkassen (EVA64-Studie) systematisch dargestellt. Am Beispiel der EVA64-Studie werden Empfehlungen für den Einsatz von GKV-Routinedaten im Bereich psychiatrischer Versorgungsforschung und allgemein abgeleitet. (1) Zunächst wird die Studie und der Einsatz der genannten Daten in dieser beschrieben und eingeordnet. (2) Dann werden die einzelnen Outcomes der Studie dargestellt und bewertet, (3) um danach Kriterien, Stärken und Einsatzmöglichkeiten dieser Daten darzustellen. (4) Abschließend werden Empfehlungen für die Weiterentwicklung von GKV-Routinedaten als Bewertungsgrundlage formuliert. The article presents the special features of an evaluation within mental health services research in Germany. The experiences of the evaluation of flexible and integrated treatment options with a global treatment budget in psychiatric hospitals based on routine data of more than 70 statutory health insurance (SHI) funds (EVA64 study) are systematically presented. Using the EVA64 study as an example, recommendations for the use of claims data in the field of mental health services research and in general are derived. (1) First, the study and the use of claims data in this study is described and classified. (2) Then, the individual outcomes of the study are presented and evaluated to (3) derive criteria, strengths and potential uses of claims data. (4) Finally, recommendations for the further development of claims data from SHI funds as a basis for evaluation are described.
Language	German
Publishing date	2024-04-02
Publisher	Georg Thieme Verlag KG
Publishing place	Stuttgart ; New York
Document type	Article
ZDB-ID	1101426-x
ISSN	1439-4421 ; 0941-3790 ; 0949-7013
ISSN (online)	1439-4421
ISSN	0941-3790 ; 0949-7013
DOI	10.1055/a-2297-5347
Database	Thieme publisher's database

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Article ; Online: Lengths of inpatient stay and sick leave of patients with mental diseases: disorder-specific effects of flexible and integrated treatment programs in Germany.

Baum, Fabian / Schmitt, Jochen / Seifert, Martin / Kliemt, Roman / Kubat, Denise / March, Stefanie / Häckl, Dennis / Pfennig, Andrea / Swart, Enno / Neumann, Anne

Translational psychiatry

2022 Volume 12, Issue 1, Page(s) 370

Abstract: Mental disorders pose a worldwide growing public health burden. One of the major challenges for healthcare systems remains to respond to the need of patients with mental disorders for continuous and flexible treatment. The EVA64 study evaluates novel ... ...

Abstract	Mental disorders pose a worldwide growing public health burden. One of the major challenges for healthcare systems remains to respond to the need of patients with mental disorders for continuous and flexible treatment. The EVA64 study evaluates novel programs of flexible and integrative treatment (FIT) in hospitals. This manuscript presents results from the evaluation of FIT hospitals in comparison to hospitals from regular routine care. In addition to data from adult patients, we also present data from affiliated child and adolescent psychiatric wards employing FIT programs. Using comprehensive claims data, primary outcomes are the utilization of inpatient care and sick leave for a priori defined clusters of mental disorders. We stratify between patients already under treatment (ongoing treatment) and patients with incident treatment cases (initial treatment) at the point of inclusion in the study. In the initial treatment group, we found a significant reduction in the length of inpatient stay of 4.1 days in FIT hospitals compared to routine care. While patients with mood affective disorders (-1.8 days) and patients with neurotic, stress-related, and somatoform disorders (-3.6 days) showed an even stronger effect of the reduction of inpatient lengths of stay, the effect was significantly weaker in patients with mental and behavioral disorders due to use of alcohol (+3.3 days). Regarding the duration of sick leave, we found no significant treatment effect of FIT programs compared to routine care. In the ongoing treatment group of adult patients, we found a significantly lower utilization of inpatient treatment by 1.3 days as well as a shorter duration of sick leave by 4.3 days in FIT hospitals compared to routine care. In the cohort of children and adolescent patients, we also did not observe a significant treatment effect in either the initial treatment group or the ongoing treatment group. Registration: this study was registered in the database "Health Services Research Germany" (trial number: VVfD_EVA64_15_003713).
MeSH term(s)	Adolescent ; Adult ; Child ; Employment ; Humans ; Inpatients ; Mental Disorders/therapy ; Psychotic Disorders ; Sick Leave
Language	English
Publishing date	2022-09-07
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2609311-X
ISSN	2158-3188 ; 2158-3188
ISSN (online)	2158-3188
ISSN	2158-3188
DOI	10.1038/s41398-022-02131-5
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Article ; Online: Agreement between self-reports and statutory health insurance claims data on healthcare utilization in patients with mental disorders.

Garcia, Tarcyane Barata / Kliemt, Roman / Claus, Franziska / Neumann, Anne / Soltmann, Bettina / Baum, Fabian / Schwarz, Julian / Swart, Enno / Schmitt, Jochen / Pfennig, Andrea / Häckl, Dennis / Weinhold, Ines

BMC health services research

2023 Volume 23, Issue 1, Page(s) 1243

Abstract: Background: Data on resource use are frequently required for healthcare assessments. Studies on healthcare utilization (HCU) in individuals with mental disorders have analyzed both self-reports and administrative data. Source of data may affect the ... ...

Abstract	Background: Data on resource use are frequently required for healthcare assessments. Studies on healthcare utilization (HCU) in individuals with mental disorders have analyzed both self-reports and administrative data. Source of data may affect the quality of analysis and compromise the accuracy of results. We sought to ascertain the degree of agreement between self-reports and statutory health insurance (SHI) fund claims data from patients with mental disorders. Methods: Claims data from six German SHI and self-reports were obtained along with a cost-effectiveness analysis performed as a part of a controlled prospective multicenter cohort study conducted in 18 psychiatric hospitals in Germany (PsychCare), including patients with pre-defined psychiatric disorders. Self-reports were collected using the German adaption of the Client Sociodemographic and Service Receipt Inventory (CSSRI) questionnaire with a 6-month recall period. Data linkage was performed using a unique pseudonymized identifier. Missing responses were coded as non-use for all analyses. HCU was calculated for inpatient and outpatient care, day-care services, home treatment, and pharmaceuticals. Concordance was measured using Cohen's Kappa (κ) and intraclass correlation coefficient (ICC). Regression approaches were used to investigate the effect of independent variables on the agreements. Results: In total 274 participants (mean age 47.8 [SD = 14.2] years; 47.08% women) were included in the analysis. No significant differences were observed between the linked and unlinked patients in terms of baseline characteristics. Total agreements values were 63.9% (κ = 0.03; PABAK = 0.28) for outpatient contacts, 69.3% (κ = 0.25; PABAK = 0.39) for medication use, 81.0% (κ = 0.56; PABAK = 0.62) for inpatient days and 86.1% (κ = 0.67; PABAK = 0.72) for day-care services. There was varied quantitative agreement between data sources, with the poorest agreement for outpatient care (ICC [95% CI] = 0.22 [0.10-0.33]) and the best for psychiatric day-care services (ICC [95% CI] = 0.72 [0.66-0.78]). Marital status and time since first treatment positively affected the chance of agreement on utilization of outpatient services. Conclusions: Although there were high levels of absolute agreement, the measures of concordance between administrative records and self-reports were generally minimal to moderate. Healthcare investigations should consider using linked or at least different data sources to estimate HCU for specific utilization areas, where unbiased information can be expected. Trial registration: This study was part of the multi-center controlled PsychCare trial (German Clinical Trials Register No. DRKS00022535; Date of registration: 2020-10-02).
MeSH term(s)	Female ; Humans ; Male ; Middle Aged ; Cohort Studies ; Insurance, Health ; Mental Disorders/therapy ; Patient Acceptance of Health Care ; Prospective Studies ; Self Report ; Adult
Language	English
Publishing date	2023-11-11
Publishing country	England
Document type	Multicenter Study ; Journal Article
ZDB-ID	2050434-2
ISSN	1472-6963 ; 1472-6963
ISSN (online)	1472-6963
ISSN	1472-6963
DOI	10.1186/s12913-023-10175-6
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Conference proceedings: Eine patientenzentrierte Versorgung basierend auf einem globalen Budget (§ 64b SGB V) führt zu Veränderungen in der Behandlung von psychisch erkrankten Menschen in psychiatrischen Kliniken in Deutschland – modellübergreifende Ergebnisse aus 12 Abschlussberichten der Evaluationsstudie EVA64

Neumann, Anne / Schmitt, Jochen / Seifert, Martin / Kliemt, Roman / Kubat, Denise / Häckl, Dennis / Pfennig, Andrea / Swart, Enno / Baum, Fabian

2022 , Page(s) 22dkvf378

Event/congress	21. Deutscher Kongress für Versorgungsforschung (DKVF); Potsdam; Deutsches Netzwerk Versorgungsforschung; 2022
Keywords	Medizin, Gesundheit
Publishing date	2022-09-30
Publisher	German Medical Science GMS Publishing House; Düsseldorf
Document type	Conference proceedings
DOI	10.3205/22dkvf378
Database	German Medical Science

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Article: Effectiveness of Global Treatment Budgets for Patients With Mental Disorders-Claims Data Based Meta-Analysis of 13 Controlled Studies From Germany.

Baum, Fabian / Schoffer, Olaf / Neumann, Anne / Seifert, Martin / Kliemt, Roman / March, Stefanie / Swart, Enno / Häckl, Dennis / Pfennig, Andrea / Schmitt, Jochen

Frontiers in psychiatry

2020 Volume 11, Page(s) 131

Abstract: Background: ...

Abstract	Background:
Language	English
Publishing date	2020-03-24
Publishing country	Switzerland
Document type	Systematic Review
ZDB-ID	2564218-2
ISSN	1664-0640
ISSN	1664-0640
DOI	10.3389/fpsyt.2020.00131
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Article ; Online: Verringerung vollstationärer Behandlungstage in psychiatrischen Kliniken mit Modellvorhaben zur patientenzentrierten Versorgung mit globalem Budget (§ 64b SGB V).

Neumann, Anne / Baum, Fabian / Seifert, Martin / Schoffer, Olaf / Kliemt, Roman / March, Stefanie / Häckl, Dennis / Swart, Enno / Pfennig, Andrea / Schmitt, Jochen

Psychiatrische Praxis

2020 Volume 48, Issue 3, Page(s) 127–134

Abstract: Objective: This analysis describes the development of the duration of inpatient and daycare treatment as well as contacts in outpatient PIA in hospitals with flexible and integrated treatment (FIT) over a three-year follow-up period.: Methods: ... ...

Title translation	Reduction of Days in Inpatient Care in Psychiatric Hospitals with Flexible and Integrated Treatment for Patient-Centered Care with a Global Budget - Results with Three-Year Follow-up from the Evaluation Study EVA64.
Abstract	Objective: This analysis describes the development of the duration of inpatient and daycare treatment as well as contacts in outpatient PIA in hospitals with flexible and integrated treatment (FIT) over a three-year follow-up period. Methods: Patients with treatment in the first year after FIT-onset and a follow-up period of three years were examined for 12 FIT-hospitals and compared with matched patients from hospitals providing routine care. Results: 11,536 patients were analyzed. In the year after first treatment, the number of inpatient days was lower in almost all FIT-hospitals compared to routine care. On the other hand, the number of daycare treatment days was mostly higher than in routine care. FIT hospitals with a pre-existing FIT-like structure showed stronger effects. PIA utilization differed between FIT-hospitals. Conclusion: This analysis supports evidence-based health policy decisions on the adoption of patient-centered global budget care concepts.
MeSH term(s)	Follow-Up Studies ; Germany ; Hospitals, Psychiatric ; Humans ; Inpatients ; Patient-Centered Care
Language	German
Publishing date	2020-11-24
Publishing country	Germany
Document type	Journal Article
ZDB-ID	124981-2
ISSN	1439-0876 ; 0303-4259
ISSN (online)	1439-0876
ISSN	0303-4259
DOI	10.1055/a-1274-3731
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