[Implementation of the psychiatric personnel regulation--an intermediate-term evaluation]

The new German Psychiatry Personnel Regulations were enforced in 1991. The aim was to set a standard for performance-adapted optimised personnel calculation for all professions taking part in stationary care and to initiate structural changes in psychiatric institutions. In general psychiatry, geronto-psychiatry, and addiction diseases, patients are classified in different categories according to the degree of disease and resulting therapeutic effort by the team taking part in therapy. In this manner personnel requirements are calculated prospectively in terms of working minutes. Realisation in Schleswig-Holstein is based on general agreements that allow evaluation, testing, and quality assurance by a graduated instrumentarium basing on valid data. A differentiated interventional management has been agreed upon. It will act in case of conflicts caused by the clinical classifications. Categorisation shows a clear trend towards classifying patients in the mandatory intensive care groups A2, S2 and G2. Correspondingly fewer patients are classified as requiring "standard treatment" and "treatment for severe and multiple sickness". This development is mainly supported by large specialised clinics and institutions with less than 50 beds. The acute-case departments of houses for central care show largely stable categorisation data during the 1 1/2 years of the survey. To evaluate the changes and trends a catalogue of structural points of view serves to verify the structural changes. Thus, criteria of quality are defined that contribute to an evaluation of the realisation of the new Personnel Regulations and support quality planning and management of the clinics.(ABSTRACT TRUNCATED AT 250 WORDS)