Clinical Trials Logo

Clinical Trial Summary

This study is an evaluation of the flexible and integrative psychiatric care model (according to § 64b of the German Social Code Book V (SGB V)) (FIT64b) in the child and adolescent psychiatry at the University Hospital Tübingen (UKT). The central concern of this evaluation is to answer the question whether FIT64b models offer advantages over standard care. The orientation of model care is a more cross-sectoral provision of services through more flexible treatment intensities.


Clinical Trial Description

The introduction of Section 64b of the German Social Code, Book V (SGB V) created the possibility of agreeing so-called FIT64b model projects for the further development of care for mentally ill people. The objective is to improve cross-sectoral care or optimize patient care. The statutory health insurance (SHI) funds AOK Baden-Württemberg and the SVLFG (as an agricultural health insurance fund) have developed a FIT64b model project in child and adolescent psychiatry (KJP) with the UKT, which will be tested for a total of eight years in the care region of Tübingen starting on 01 October 2017. The core of the model care is the Therapeutic Intensive Treatment in the Outpatient Setting (TIBAS, from the German abbreviation of "Therapeutische Intensivbehandlung im Ambulanten Setting"). The goal of this model care is to provide more cross-sectoral service delivery through more flexible treatment intensities. The creation of TIBAS as an intensive outpatient form of treatment is intended to enable earlier discharge from the full inpatient setting. Four TIBAS levels have been implemented, representing different treatment intensities and frequencies, which can be flexibly deployed according to patient needs. A person-centered case manager accompanies patients throughout the treatment period. If necessary, the patients, but especially the family members, are accompanied by the social service of the AOK Baden-Württemberg and supported with regard to stabilizing the overall care situation (psychosocial counseling and networking with other care structures, etc.). For patients fulfilling the diagnostic criteria for either anorexia nervosa or moderate depression, direct access to TIBAS is possible without prior hospitalization. The aim of the evaluation is to examine the achievement of the objectives of the FIT64b model project on the basis of anonymized claims data and primary data to be collected and to assess the transferability of the care approach to standard care. The main goals of the model project are to shorten the duration of inpatient stays while intensifying outpatient forms of treatment, to reduce the cumulative psychiatric treatment duration and the emergency admission rate, to reduce the symptom burden, to accelerate the return to psychosocial living conditions and to increase the quality of life. Stabilization of the family's overall care situation will be used to sustain these improvements. Through qualitative research methods, the experiences with and the subjective benefit of the social service of the AOK Baden-Württemberg as well as the cooperation of this social service with the UKT will be examined in more detail. The costs of the FIT64b model care should not exceed those of the standard care or, at a maximum of the same costs, better results should be achieved with regard to the above-mentioned patient-related goals. The effectiveness, costs, and cost-effectiveness of the FIT64b model hospital compared to standard care are examined. The study presented here is a controlled cohort study which utilizes claims data as well as primary data. It will employ quantitative analyses of anonymized SHI data (Module A), quantitative analyses of questionnaires (Module B), and qualitative analyses of semi-structured interviews and a focus group (Module C). The controlled design is based on the fact that information of patients from the intervention hospital, the UKT, is compared to information of comparable patients from structurally similar hospitals of child and adolescent psychiatry in the same federal state (Petzold et al, Gesundheitswesen 2019, 81(1):63-71). ;


Study Design


Related Conditions & MeSH terms


NCT number NCT04727359
Study type Observational
Source Technische Universität Dresden
Contact Anne Neumann, PhD
Phone +49 351 458
Email anne.neumann@uniklinikum-dresden.de
Status Recruiting
Phase
Start date November 17, 2021
Completion date December 2024

See also
  Status Clinical Trial Phase
Completed NCT02115438 - A Cohort Study for Occupational Stress Induced Early Embryonic Death N/A
Recruiting NCT05290415 - Host DNA Methylation for Endometrial Cancer Screening
Recruiting NCT04382534 - A Cross-sectional and Cohort Study of COVID-19 Patients With Post - Discharge Dysfunction
Completed NCT05538819 - The Effects of Glimepiride in Patients With Type 2 Diabetes and Chronic Heart Failure
Completed NCT00679640 - Observational Usage and Efficacy Study of Candesartan in Heart Failure Treatment in France N/A
Recruiting NCT06010316 - A Prospective Single-center Cohort Study of Surgical Treatment of Chronic Rhinosinusitis
Recruiting NCT03768271 - APACHE Cohort (A Psoriatic Arthritis CoHort)
Recruiting NCT06021691 - Gestational Diabetes Mother-infant Cohort
Recruiting NCT06121804 - Immunosuppressants to Postoperative Infection and Death
Recruiting NCT04839796 - Northeastern Taiwan Community Medicine Research Cohort
Completed NCT04561050 - Prediction of Massive Transfusion in Trauma Patients
Recruiting NCT06355206 - Natural Course and Therapeutic Effect of Recurrent Acute Pancreatitis