Flexible and Integrative Psychiatric Care Based on a Global Treatment Budget: Comparing the Implementation in Germany and Poland
Background: The past decade has witnessed the establishment of flexible and integrative treatment (FIT) models in 55 German and Polish psychiatric catchment areas. FIT is based on a global treatment budget (GTB), which integrates funding of all acute psychiatric hospital services for a regional popu...
| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-01-01
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| Series: | Frontiers in Psychiatry |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fpsyt.2021.760276/full |
| _version_ | 1818750164439924736 |
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| author | Julian Schwarz Andrzej Cechnicki Jan Godyń Laura Galbusera Daria Biechowska Beata Galińska-Skok Izabela Ciunczyk Yuriy Ignatyev Felix Muehlensiepen Felix Muehlensiepen Bettina Soltmann Jürgen Timm Sebastian von Peter Marek Balicki Jacek Wciórka Martin Heinze Martin Heinze |
| author_facet | Julian Schwarz Andrzej Cechnicki Jan Godyń Laura Galbusera Daria Biechowska Beata Galińska-Skok Izabela Ciunczyk Yuriy Ignatyev Felix Muehlensiepen Felix Muehlensiepen Bettina Soltmann Jürgen Timm Sebastian von Peter Marek Balicki Jacek Wciórka Martin Heinze Martin Heinze |
| author_sort | Julian Schwarz |
| collection | DOAJ |
| description | Background: The past decade has witnessed the establishment of flexible and integrative treatment (FIT) models in 55 German and Polish psychiatric catchment areas. FIT is based on a global treatment budget (GTB), which integrates funding of all acute psychiatric hospital services for a regional population. Prior research has identified 11 specific program components of FIT in Germany. In this paper we aim at assessing the applicability of these components to the Polish context and at comparatively analysing FIT implementation in Poland and Germany.Methods: Qualitative interviews about the applicability of the 11 FIT-specific components were conducted with the program managers of the Polish FIT models (n = 19). Semi-quantitative data on the FIT-specific components were then collected in 19 Polish and 10 German FIT models. We assessed the grading of each component, their overall degree of implementation and compared them between the two countries. In all study hospitals, structural and statistical parameters of service delivery were collected and compared.Results: The qualitative results showed that the German FIT-specific components are in principle applicable to the polish context. This allowed the comparative assessment of components grading and degree of implementation, which showed only subtle discrepancies between German and Polish FIT models. The little discrepancies point to specific aspects of care such as home treatment, peer support, and cooperation with non-clinical and social welfare institutions that should be further integrated in the components' definition.Conclusions: The specific program components of FIT as first defined from the German experience, serves as a powerful tool to measure, and evaluate implementation of integrated psychiatric care both within and between health systems. |
| first_indexed | 2024-12-18T04:15:19Z |
| format | Article |
| id | doaj.art-3a8c2c491c4045bdae864af47ce7d4d0 |
| institution | Directory Open Access Journal |
| issn | 1664-0640 |
| language | English |
| last_indexed | 2024-12-18T04:15:19Z |
| publishDate | 2022-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Psychiatry |
| spelling | doaj.art-3a8c2c491c4045bdae864af47ce7d4d02022-12-21T21:21:22ZengFrontiers Media S.A.Frontiers in Psychiatry1664-06402022-01-011210.3389/fpsyt.2021.760276760276Flexible and Integrative Psychiatric Care Based on a Global Treatment Budget: Comparing the Implementation in Germany and PolandJulian Schwarz0Andrzej Cechnicki1Jan Godyń2Laura Galbusera3Daria Biechowska4Beata Galińska-Skok5Izabela Ciunczyk6Yuriy Ignatyev7Felix Muehlensiepen8Felix Muehlensiepen9Bettina Soltmann10Jürgen Timm11Sebastian von Peter12Marek Balicki13Jacek Wciórka14Martin Heinze15Martin Heinze16Department of Psychiatry and Psychotherapy, Brandenburg Medical School, Immanuel Clinic Rüdersdorf, Rüdersdorf, GermanyCommunity Psychiatry and Psychosis Research Centre, Jagiellonian University Medical College, Krakow, PolandPsychosis Research Unit, Association for the Development of Community Psychiatry and Care, Krakow, PolandDepartment of Psychiatry and Psychotherapy, Brandenburg Medical School, Immanuel Clinic Rüdersdorf, Rüdersdorf, GermanyDepartment of Public Health, Institute of Psychiatry and Neurology, Warsaw, PolandDepartment of Psychiatry, Medical University of Bialystok, Białystok, PolandMiddle Pomeranian Mental Health Centre “Medison”, Koszalin, PolandCentre for Health Services Research Brandenburg, Brandenburg Medical School, Rüdersdorf, GermanyCentre for Health Services Research Brandenburg, Brandenburg Medical School, Rüdersdorf, GermanyFaculty of Health Sciences Brandenburg, Brandenburg Medical School, Neuruppin, GermanyDepartment of Psychiatry and Psychotherapy, Medical Faculty, Carl Gustav Carus University Hospital, Technical University Dresden, Dresden, Germany0Biometry Section, Competence Centre for Clinical Trials, University of Bremen, Bremen, GermanyDepartment of Psychiatry and Psychotherapy, Brandenburg Medical School, Immanuel Clinic Rüdersdorf, Rüdersdorf, Germany1Pilot Program Office of the National Mental Health Program, Institute of Psychiatry and Neurology, Warsaw, Poland1Pilot Program Office of the National Mental Health Program, Institute of Psychiatry and Neurology, Warsaw, PolandDepartment of Psychiatry and Psychotherapy, Brandenburg Medical School, Immanuel Clinic Rüdersdorf, Rüdersdorf, GermanyCentre for Health Services Research Brandenburg, Brandenburg Medical School, Rüdersdorf, GermanyBackground: The past decade has witnessed the establishment of flexible and integrative treatment (FIT) models in 55 German and Polish psychiatric catchment areas. FIT is based on a global treatment budget (GTB), which integrates funding of all acute psychiatric hospital services for a regional population. Prior research has identified 11 specific program components of FIT in Germany. In this paper we aim at assessing the applicability of these components to the Polish context and at comparatively analysing FIT implementation in Poland and Germany.Methods: Qualitative interviews about the applicability of the 11 FIT-specific components were conducted with the program managers of the Polish FIT models (n = 19). Semi-quantitative data on the FIT-specific components were then collected in 19 Polish and 10 German FIT models. We assessed the grading of each component, their overall degree of implementation and compared them between the two countries. In all study hospitals, structural and statistical parameters of service delivery were collected and compared.Results: The qualitative results showed that the German FIT-specific components are in principle applicable to the polish context. This allowed the comparative assessment of components grading and degree of implementation, which showed only subtle discrepancies between German and Polish FIT models. The little discrepancies point to specific aspects of care such as home treatment, peer support, and cooperation with non-clinical and social welfare institutions that should be further integrated in the components' definition.Conclusions: The specific program components of FIT as first defined from the German experience, serves as a powerful tool to measure, and evaluate implementation of integrated psychiatric care both within and between health systems.https://www.frontiersin.org/articles/10.3389/fpsyt.2021.760276/fullintegrated mental health carehome treatmentglobal budget paymenthealth service researchmental health systems researchprocess evaluation |
| spellingShingle | Julian Schwarz Andrzej Cechnicki Jan Godyń Laura Galbusera Daria Biechowska Beata Galińska-Skok Izabela Ciunczyk Yuriy Ignatyev Felix Muehlensiepen Felix Muehlensiepen Bettina Soltmann Jürgen Timm Sebastian von Peter Marek Balicki Jacek Wciórka Martin Heinze Martin Heinze Flexible and Integrative Psychiatric Care Based on a Global Treatment Budget: Comparing the Implementation in Germany and Poland Frontiers in Psychiatry integrated mental health care home treatment global budget payment health service research mental health systems research process evaluation |
| title | Flexible and Integrative Psychiatric Care Based on a Global Treatment Budget: Comparing the Implementation in Germany and Poland |
| title_full | Flexible and Integrative Psychiatric Care Based on a Global Treatment Budget: Comparing the Implementation in Germany and Poland |
| title_fullStr | Flexible and Integrative Psychiatric Care Based on a Global Treatment Budget: Comparing the Implementation in Germany and Poland |
| title_full_unstemmed | Flexible and Integrative Psychiatric Care Based on a Global Treatment Budget: Comparing the Implementation in Germany and Poland |
| title_short | Flexible and Integrative Psychiatric Care Based on a Global Treatment Budget: Comparing the Implementation in Germany and Poland |
| title_sort | flexible and integrative psychiatric care based on a global treatment budget comparing the implementation in germany and poland |
| topic | integrated mental health care home treatment global budget payment health service research mental health systems research process evaluation |
| url | https://www.frontiersin.org/articles/10.3389/fpsyt.2021.760276/full |
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