Effective outpatient care in the community: One German way

Abstract

Aim: To evaluate the effectiveness of the German model of community psychiatry at the Medical University of Hanover. Patients and Methods: Three hundred and thirteen (313) patients treated over a period of ten years (1987-1996) at the Social Psychiatry Department of the University of Hanover were anonymously grouped on basis of their score on a Psychosocial Risk Score (PSR). Those admitted to the study were between 18 and 60 and excluded addictions and psycho-organic disorders. Results: There was a highly significant correlation between psychosocial risks (indicators of the chronicity and severity of psychiatric disorder, the psychiatric first diagnosis, the age of onset of disease and duration since onset of disease) at the first therapeutic contact and future Long Stay Hospitalization (LSH). The highest coefficient was found for the criterion of the situation of employment, followed by primary income living situation, duration since onset of disease, type of initial diagnosis and age at onset of disease. Conclusion: The simple sum core (PRS) allows calculating the risk of LSH on the basis of a small number of characteristics drawn from usually registered psychiatric base data and can help psychiatric services to concentrate on high risk patients.

Keywords

• community psychiatry
• german model
• effectiveness