Outpatient psychiatric care

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Outpatient psychiatric care (in SGB V: Psychiatric home nursing) is a community- oriented psychiatric care offer and is one of the health insurance benefits according to Book V of the Social Code (SGB V). According to § 37 SGB ​​V, it can be prescribed by a doctor as a special case of home nursing for certain mental disorders, whereby it is intended to avoid or shorten hospital stays.

Outpatient psychiatric care (APP) is an outpatient service. The aim is that people with mental disorders "can lead a dignified, independent life in their usual context". Care in your own home should also include the spatial and personal environment and strengthen the patient in his accustomed social relationships. For this purpose, visits by psychiatric nurses are carried out in a rhythm based on the needs of the patient between once a month and several times a day .

In addition to establishing stable working relationships, the determination and documentation of the need for help, coping with everyday demands, the creation of a daily structure, patient observation, support for medical treatment, strengthening of personal responsibility, psychoeducation , crisis recognition and management as well as the independent handling of medication belong to the tasks the APP. It is based on the voluntary acceptance of the offer by the patient.

Legal framework in Germany

Section 14 of Book 11 of the Social Code (SGB XI) has also included psychiatric clinical pictures since 1995. According to § 37 SGB V, outpatient care can be prescribed to avoid or shorten hospital stays and to ensure treatment by resident psychiatrists. The HKP guidelines (Section 92 Paragraph 1 Clause 2 No. 6 and Paragraph 7 SGB V) have been creating a uniform basis for outpatient psychiatric care throughout Germany since 2005. However, since the guidelines do not contain any implementation provisions and these have to be negotiated individually by each potential service provider, there is still no nationwide coverage in Germany. From 2004, outpatient psychiatric care was established at individual locations within the framework of integrated supply contracts (SGB V §§ 140 ff.). These special contracts enable remuneration models, transitional regulations and diagnostic inclusions that differ significantly from the HKP guidelines or the standard contracts. With this, an innovative care structure was created - even before the guidelines were adopted - which stands out positively from standard care in terms of performance and cost efficiency.

Diagnoses

APP can be prescribed for the following diagnoses:

  • F00.1 Dementia in Alzheimer's disease, with late onset (type 1)
  • F01.0 Vascular dementia with acute onset
  • F01.2 Subcortical vascular dementia
  • F02.0 Dementia in Pick's disease
  • F02.1 Dementia in Creutzfeldt-Jakob disease
  • F02.2 Dementia in Huntington's disease
  • F02.3 Dementia in primary Parkinson's syndrome
  • F02.4 Dementia in HIV disease
  • F02.8 Dementia in diseases classified elsewhere
  • F04. Organic amnesic syndrome, not caused by alcohol or other psychotropic substances
  • F05.1 Delirium in dementia
  • F06.0 Organic hallucinosis
  • F06.1 Organic catatonic disorder
  • F06.2 Organic delusional disorder
  • F06.3 Organic affective disorders
  • F06.4 Organic anxiety disorder
  • F06.5 Organic dissociative disorder
  • F06.6 Organic emotionally labile disorder
  • F07.0 Organic personality disorder
  • F07.1 Post-encephalitic syndrome
  • F07.2 Organic psychosyndrome after head trauma
  • F20 Schizophrenia
  • F21 Schizotypic disorder
  • F22 persistent delusional disorder
  • F24 Induced delusional disorder
  • F25 Schizoaffective disorder
  • F30. Manic episode
  • F31 bipolar affective disorder with the exception of: F31.7 - F31.9
  • F32 .-- Depressive episode with the exception of: F32.0, F 32.1 and F 32.9
  • F33.- Recurrent depressive disorder with the exception of: F33.0, F 33.4, F 33.8 and F33.9
  • F41.0 panic disorder, even if it is due to social phobias
  • F41.1 Generalized anxiety disorder
  • F42.1 Predominantly compulsive acts
  • F42.2 Obsessive thoughts and actions, mixed
  • F43.1 Post-traumatic stress disorder
  • F53.1 Severe psychological behavior disorder in the puerperium
  • F60.3 Emotional unstable personality disorder

See also

literature

  • Bruno Hemkendreis, Volker Haßlinger: Outpatient psychiatric care. Psychiatrie-Verlag, Cologne 2014, ISBN 978-3-88414-579-1 .
  • Hilde Schädle-Deininger : Basic knowledge of psychiatric care. Psychiatrie-Verlag, Bonn 2008, ISBN 978-3-88414-458-9 .
  • Hilde Schädle-Deininger: Specialist care psychiatry. Urban & Fischer 2006, ISBN 3-437-27120-2 .
  • Mirjam Gaßmann, Werner Marschall, Jörg Utschakowski (eds.): Psychiatric health and nursing - Mental Health Care. Springer Medizin Verlag, Heidelberg 2006, ISBN 3-540-29432-5 .
  • Dorothea Sauter, Chris Abderhalden , Ian Needham (Eds.): Textbook Psychiatric Care . Verlag Hans Huber, Bern / Göttingen / Toronto / Seattle 2004, ISBN 3-456-83837-9 .
  • Hilde Schädle-Deininger, Ulrike Villinger: Practical psychiatric care. Psychiatrie-Verlag, ISBN 3-88414-182-1 .
  • Dorothea Sauter, Dirk Richter: Experts for everyday life - professional care in psychiatric fields of action . Bern / Göttingen / Toronto / Seattle, 1999, ISBN 3-88414-236-4 .
  • M. Holnburger: Nursing standards in psychiatry . Munich / Jena 1999, ISBN 3-437-26200-9 .

Web links

Individual evidence

  1. ↑ a b What is psychiatric care. Publication by BAPP - Federal Outpatient Psychiatric Care Initiative, (online) , accessed on May 19, 2014.
  2. ↑ Directive on the regulation of home nursing, as of January 17, 2019, pp. 34–35; accessed on April 3, 2019