Chronic physical illness F00-F99
Conditions
Interventions
Group 1: The structural reformation is considered to be a complex intervention. Therefore, its evaluation demands different methodical approaches. A mixed-methods-design (quantitative, qualitative) al
Sponsors
Universitätsklinikum Gießen und Marburg, Klinik für Psychosomatik und Psychotherapie
Eligibility
Sex/Gender
All
Age
18 Years to 79 Years
Inclusion criteria
Inclusion criteria: Sample: subjects with sufficient German language skills and cognitive proficiency; informed consent to participate in the study. Furthermore, the three target groups of the patient sample have to meet the following criteria: (A) subjects who wanted to see a psychotherapist but were unable to achieve a primary psychotherapeutic face-to-face contact, (B) subjects who had at least one psychotherapeutic intervention from the 1st quarter of 2012 to the 1st quarter of 2017 (pre-reformation), (C) subjects who had at least one psychotherapeutic intervention from the 1st quarter of 2018 to the 4th quarter of 2019 (post-reformation) Focus groups, interviews and survey with psychotherapists: entry in the medical register of the KBV under the group "psychological psychotherapists" or "medical psychotherapists"; treatment of adults; psychotherapeutic work in practice since at least 2015 (2 years prior to reform); informed consent. Focus groups and survey with primary care physicians: entry in the medical register of the KBV under the group "primary care physician (internal or general medicine); primary care work since at least 2015 (2 years prior to reform); informed consent. Secondary data KBV billing data: data from the full surveys of all KBV insured persons (billing services from 2015 to 2019). BARMER health insurance data: data on the total population of BARMER policyholders (accounting data from 2009 to 2019)
Exclusion criteria
Exclusion criteria: Organic, including symptomatic, mental disorders (ICD-10: F00-F09); mental retardation (ICD-10: F70-F79); age 79 years
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Health insurance data (BARMER): 1) utilization rates of psychotherapeutic appointments, and 2) reduction of waiting periods between the primary contact and the start of the psychotherapeutic treatment. | — |
Secondary
| Measure | Time frame |
|---|---|
| Primary data: - patient sample: subjective patient outcomes also regarding experiences within the psychotherapeutic systems and the presence of complex diseases (health problems, course of the health problems, medical referral, satisfaction with waiting time and treatment, quality of life, morbidity); access barriers - focus groups/surveys with general practitioners and psychotherapists: effects of the reformation from the perspective of the service providers (knowledge about the reformation, implementation process, task changes, benefits, adverse effects, cooperation between general practitioners and psychotherapists, referral problems, situation of patients with complex diseases, need for change) - interviews with psychotherapists and practice observations: implementation of the reformation with regard to formal aspects and content (indications, methods and techniques, networking, best practice examples); organizational context Secondary data: - data from the BARMER health insurance company: health economic changes (direct treatment costs, indirect costs like time of work incapacity) - data from the National Association of Statutory Health Insurance Physicians: changes in care procedures (services, spectrum of diagnoses, disease severity, variability across the psychotherapists, regional impacts) | — |
Countries
Germany
Contacts
Public ContactHanna Kampling
Universitätsklinikum Gießen und Marburg, Klinik für Psychosomatik und Psychotherapie
Outcome results
None listed