BACKGROUND: Quality management is an important management tool in modern health care systems. This applies also to the mental health care system, where in the past decade many concepts have been developed on how to implement quality management appropriately and successfully. However, for the German speaking countries there are only very few studies on the evaluation of therapy outcome in psychiatric inpatient populations available, furthermore they deal primarily with diagnostic subgroups. The aim of this study was to develop a method to assess the quality of therapy on regular psychiatric admission wards. An important aspect was to include all diagnostic subgroups of a psychiatric inpatient population. METHODS: In an explorative field study and by means of a specially designed evaluation method, therapy courses of a psychiatric inpatient population were assessed. Indicators of therapy outcome were: psychopathology, level of psychosocial functioning, motivation of the patient for therapy, suicide attempts, legal status of the patient, patient violence and coercive treatment of the patient. The following assessment and rating scales were used: Brief Psychiatric Rating Scale (BPRS), Hamilton Depression Rating Scale (HAMD), Global Assessment of Function (GAF), Social and Occupational Functioning Assessment Scale (SOFAS) and the Symptom-Checklist SCL-9. RESULTS: Changes in the courses of therapy of a psychiatric inpatient population in all diagnostic subgroups in the dimensions psychopathology and level of social functioning could be reproduced significantly using BPRS, HAMD and GAF scales. Difference values T(1)-T(2) were 6.6 +/- 6.9 (p = 0.019) in BPRS, 5.1 +/- 8.1 (p = 0.029) in HAMD and -5.5 +/- 10.1 (p = 0.028) in GAF. The entire battery of rating scales was successfully applied in 32% of all patients (drop out rate: 68%). In the subgroup of immigrant patients the entire battery of rating scales could be applied only in 17.4%, which accounts for a significantly higher drop out rate (82.6%; p = 0.067). DISCUSSION: Using the presented evaluation system therapy outcome and quality of therapy are easy to assess. The results of the quality assessment can be used in further therapeutic processes.
BACKGROUND: Quality management is an important management tool in modern health care systems. This applies also to the mental health care system, where in the past decade many concepts have been developed on how to implement quality management appropriately and successfully. However, for the German speaking countries there are only very few studies on the evaluation of therapy outcome in psychiatric inpatient populations available, furthermore they deal primarily with diagnostic subgroups. The aim of this study was to develop a method to assess the quality of therapy on regular psychiatric admission wards. An important aspect was to include all diagnostic subgroups of a psychiatric inpatient population. METHODS: In an explorative field study and by means of a specially designed evaluation method, therapy courses of a psychiatric inpatient population were assessed. Indicators of therapy outcome were: psychopathology, level of psychosocial functioning, motivation of the patient for therapy, suicide attempts, legal status of the patient, patient violence and coercive treatment of the patient. The following assessment and rating scales were used: Brief Psychiatric Rating Scale (BPRS), Hamilton Depression Rating Scale (HAMD), Global Assessment of Function (GAF), Social and Occupational Functioning Assessment Scale (SOFAS) and the Symptom-Checklist SCL-9. RESULTS: Changes in the courses of therapy of a psychiatric inpatient population in all diagnostic subgroups in the dimensions psychopathology and level of social functioning could be reproduced significantly using BPRS, HAMD and GAF scales. Difference values T(1)-T(2) were 6.6 +/- 6.9 (p = 0.019) in BPRS, 5.1 +/- 8.1 (p = 0.029) in HAMD and -5.5 +/- 10.1 (p = 0.028) in GAF. The entire battery of rating scales was successfully applied in 32% of all patients (drop out rate: 68%). In the subgroup of immigrant patients the entire battery of rating scales could be applied only in 17.4%, which accounts for a significantly higher drop out rate (82.6%; p = 0.067). DISCUSSION: Using the presented evaluation system therapy outcome and quality of therapy are easy to assess. The results of the quality assessment can be used in further therapeutic processes.
Authors: B Janssen; C Burgmann; U Habel; T Held; P Hoff; M Jänner; H Mecklenburg; C Prüter; A Ruth; H Sass; F Schneider; W Gaebel Journal: Nervenarzt Date: 2000-05 Impact factor: 1.214
Authors: Julia Engl; Alexander Tschoner; Markus Laimer; Maria Rettenbacher; W Wolfgang Fleischhacker; Josef R Patsch; Christoph Ebenbichler Journal: Wien Klin Wochenschr Date: 2006-05 Impact factor: 1.704
Authors: Harold Alan Pincus; Ann E K Page; Benjamin Druss; Paul S Appelbaum; Gary Gottlieb; Mary Jane England Journal: Am J Psychiatry Date: 2007-05 Impact factor: 18.112
Authors: B Janssen; M Jänner; F Schneider; W Gaebel; C Burgmann; T Held; P Hoff; C Prüter; H Sass; H Mecklenburg; A Ruth Journal: Psychiatr Prax Date: 1998-11
Authors: Stefan M Bartusch; Hermann Elgeti; Peter Bastiaan; Wielant Machleidt; Marc Ziegenbein Journal: Clin Pract Epidemiol Ment Health Date: 2006-05-22
Authors: Bettina Soltmann; Anne Neumann; Stefanie March; Ines Weinhold; Dennis Häckl; Roman Kliemt; Fabian Baum; Marcel Romanos; Julian Schwarz; Sebastian von Peter; Yuriy Ignatyev; Katrin Arnold; Enno Swart; Martin Heinze; Jochen Schmitt; Andrea Pfennig Journal: Front Psychiatry Date: 2021-06-01 Impact factor: 4.157