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[How community oriented is psychiatric care in Germany?]
1Abteilung für Epidemiologie, Sozialmedizin und Gesundheitssystemforschung, Medizinische Hochschule Hannover. bramesfeld.anke@mh-hannover.de
Psychiatrische Praxis
|July 23, 2003
Summary
German psychiatric reform shows varied community integration. While smaller western and eastern states excel in community-oriented hospital care, large western states lag, and outpatient services are sparse in the East.
Area of Science:
- Psychiatry
- Health Services Research
- Sociology
Background:
- German psychiatric reform initiated 25 years ago in the West and 12 years ago in the East.
- The study assesses the current status of community orientation in German psychiatry post-reform.
Purpose of the Study:
- To investigate the community orientation of German psychiatry after significant reform periods.
- To identify regional differences in the implementation of community-based psychiatric care.
Main Methods:
- Analysis of secondary data on psychiatric services in Germany.
Main Results:
- Community orientation in hospital care is more advanced in smaller western German states and eastern German states.
- Large western states retain hospital-centric inpatient structures; outpatient care is less developed in East Germany.
- States with better hospital community orientation provide less sheltered accommodation.
Conclusions:
- Psychiatric reform remains incomplete, especially regarding hospital care in large western states and sheltered housing provision.
- Resistance from hospital stakeholders may hinder community integration in large western hospitals.
- Weak incentives for supported housing and under-provision of sheltered accommodation pose risks.