Integrierte Versorgung von Patienten mit psychotischen Erkrankungen nach dem Hamburger Modell: Teil 1

Zusammenfassung

Ziel der Studie: Das „Hamburger Modell“ bezeichnet ein integriertes Versorgungsmodell für schwer erkrankte Psychose Betroffene nach § 140 SGB V.

Methodik: Das Behandlungsmodell beinhaltet eine sektorübergreifende und langfristige Behandlung in einem Netzwerk bestehend aus dem Arbeitsbereich Psychosen des Universitätsklinikums Hamburg-Eppendorf (UKE) und niedergelassenen Psychiatern. Es umfasst sogenanntes therapeutisches Assertive Community Treatment (ACT) durch ein hoch spezialisiertes Behandlungsteam sowie alle voll- und teilstationären und ambulanten Behandlungen.

Ergebnisse und Schlussfolgerung: Im vorliegenden Artikel werden die erkrankungs- und versorgungsspezifischen Rationalen sowie Strukturen und Inhalte der integrierten Versorgung nach dem Hamburger Modell dargestellt. Zudem werden die Ergebnisse einer 12-monatigen Vorstudie (ACCESS-Studie) zum Vergleich des Hamburger Modells mit einer Referenzbehandlung (ohne therapeutisches ACT) hinsichtlich der Effektivität und Effizienz berichtet.

Abstract

Objective: The „Hamburg model“ designates an integrated care model for severely ill patients with psychotic disorders financed by the health insurance system in accordance with § 140 SGB V.

Methods: It comprises comprehensive and long-term treatment within a regional network of the psychosis center of the University Medical Center Hamburg-Eppendorf (UKE) and private psychiatrists. The treatment model consists of therapeutic assertive community treatment (ACT) provided by a highly specialized treatment team and need-adapted in- and outpatient care.

Results and conclusions: The present article summarizes the disease- and treatment-specific rationales for the model development as well as the model structure and treatment contents. The article further summarizes the effectiveness and efficiency results of a study comparing the Hamburg model and treatment as usual (without ACT) within a 12-month follow-up study (ACCESS trial).

Schlüsselwörter

integrierte Versorgung - Assertive Community Treatment (ACT) - Zuhausebehandlung - Psychosen - Schizophrenie - bipolare Störung - Outcome

Keywords

integrated care - Assertive Community Treatment (ACT) - hometreatment - psychosis - schizophrenia - bipolar disorder - outcome

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