te n d e n W u n s c h n a c h e in e r n E in z e lz im m e l ln h a ltlic h n e u e A s p e k teb e tfe ffe ne in e n e in irjh ls a m e re nU m g a n gd e s P e rc o n a ls n lit

F a c h k li n ik a ls a u c h d ie e iD e rp s y c h irtrjs c h e nA b te ilu n g g e w ic h r e ne in e e .tb lg re ic h e T h e ra p ie ,

g e s c h e D tw e r d e n k 6 n n e n . M e t h o d e :A u s - g \u20ac h e n dv o n d e r L ite ra tu ru n d k lin is c h e fB e u r te ilu n gw u |d e e in In s tjtu tjo n a lis ie r u n g s in d e x ( lll

r a n c e i n c o m m u n i r y m e n t a l h e a l t h c a r e . Y e t . t h e y a r e o f t e n d i f f i - c u l t a n d e x p e n s i v eI o c o n d u c t .T h i s s t r d y e x p l o . e sw h e t h e r a n d , ifs o , to w h a t e x te n td ife c t tfe a tm e n tc o s tsa s p a id b y in s u ra n c e c o m p a n ie sa n d s o c ia lw e lfa r cin th e C e |n la Dh \u20ac a lth c a r e s y s te m c a n b e e s tim a te d th ro u g h a s in p le h s titu tio n a lis a tio n -ln d e x - M e t h o d : E a s e d o n l h e l i t e f a t u r e a n d c l i n i c a l l L r d g m e n t ,

s u p p o rte d h o u s in g ,lo n g -te rm d a y c a r e .p a ftiil h o s p ita lis a tio na n d fu ll h o s p ita lis a tio rp ro g fa n r e s . A s p a rt o f a c o ' n p f e h e n s i v ee v a l u a t i o no f a n r o d e li n s t i t u t i o n i b f c o m m u n i t y m e n t a l h e a l t h c a . e i n B e r l i n , a c l u a l l y D a id t r e a t m e n t c o s t s a n d l n s t i t u n o n a l i s a t i o nI n d e x ll1 )w e re i d e n t i f i e d f o r 1 1 9 4 p :Iie n ts o v e ra to ta lp e rio d o i2 3 y e a rs :n d c o m p a r e d w i l h e a c h o t h e r R \u20ac s u l t s : T h e P e a r s o nc o f r e l a t i o n c o e f f i c i e n t b e t l v e e n 1 l .rn dp a idc o s tsw a s0 .9 7 (p < 0 ,0 0 1 ).lnc a lc u la tio n s

r o o .c o n c l u s i o n s :T h e l n s t i r U r r o n : l i r a t j o n I n d e xp ro v id e sa s u i f i c i e n t l y p re c is ee s l i m a t e o f d i r e c t c o s t si sp a id b y i n s u r a n c ec o m p a n ie sa n d s o c i a l w e l f a r c f o f d i f f e r e n t f o r m s o l c a r e i n c o m m u n i ty b a s e din s tilo tio n s a n d h o s p ita ls .

D j e K o s t e n v o n u n t e r s c h j e d l i c h e n B e h a n d l u n g e nu n d V e rs o F g u n g s fo rm e ns p je le n e in e ,u n e h n e n d e R o lle in m e d iz in is c h e r P r a x i s u n d F o r s c h u n g u n d b e e i n f l u s s e n k l i n i s c h e w ie a u c h g e - s u n d h e i t s p o l i t i s c h eE n t s c h e i d u n g e ni n i m m e r s t : i r k e r e rW e i s e 1 1 ,2 1 .

m e t b o d i s c h s c h w i \u20ac r i g o n d v o r a l l e m a u f w a n d ig u n d d a d u r c h a u c h t e u e r s e i n k o n n e n . V o r d i e s e n H i n t e F g tu n d k ijn n te e in e V e re in fa c h u n gd e f E e re c h n u n gv o n B e h a n d l u n g s k o s t e nf i l r V e r s o r g u n g s p l a n e r

V c rs o rg u rg fu f u n te |s c h ie d lic h eZ w e c k es tim u lie r e n -Z ie ld e r h ie rb c ric h te - te n U n te rs u c b u n gw rr

o r d n e t e i n e n rT a g i n v o l l s t a t i o n e . e rB e h a n d lu n g d \u20ac n W e .t 3 rn d in te 'ls ta tio n a .e rV e B o rg u D gd e r W e .t 2 z u u n d w u rd ei n

e i n e S c h i i t z u n g d e r t e n i g e n K o s t e n e r m o g l i c h t ,d ie v o n d e n K o s te n trig e fn fiir d ie k o m p le m e n t;re ,t e ih ta tio n ;ireu n d v o lh ta tio - D jre V e |s o rg rn gg e z a h lrw e rd e n .

r e k t e n e d i z i n i s c h \u20ac K o s t e n v e r s t a n d e n , d i e d u r c h a m b u l a n t e , k o m p le m e n t;re ,t e i l - u n d v o l l s t a t i o n i i r e 8 \u20ac h a n d l u n g e n t s t a n d e n s in d .N ic h tb e r0 c k s ic h tig ted ire k te K o s te ns in d d ie d u rc h a n b u la n te h a u s - o d e r f a c h a r z d i c h \u20ac l . e i s t u n g e n s o w i e d u r c h d e n s o r i a lp s y c h ia ts c h e nD ie D s t.

fiir v o llu n d te ih ta tio n ;i, re A u fe n th a lt\u20acw L r.d e ne in e . Z ffa m m e n s te lh n g d \u20ac r A rb e its g e n e in s c h a ftd e f K fa n k e n k a s s e n v e rb e n d e

w u rd e n E \u20ac w e |tu n g e nim k lin is c h e n T e a md e rA b te ilu n g fn rS o z i a l p s y c h i a t d e d e f F r e i e n U n i v e r s i t e tB e r l i n n e u d i s k u t i e f t u n d i m K o n s \u20ac n s v e fa h re np ro s p \u20ac k tivfe s tg e le g t.

B e tfe u u rg s a u fw a n da u s k lin is c h e rS ic h ru n d rm V e fh a ltn is z u d \u20ac n o b ig e nW e rte n a b z u b jld e n .Ind ie s e m V e rfrh .e n w u rd e n firl d a s b \u20ac t r e u t \u20ac W o h n e n \u20ac i n W e n v o n 0 . 4 u n d f i l r d i e B e r r e u u n g i n

w rfd eje w e ils d ie P o n k c z :h ld e r In s tjtu tio n m it d e m h o c h s te nP ro te k tio n s g frdg e w ib lt. 5 0 w (fd eje d e m P a tje n te nfiir je d e n T a g e in W e rt z w is c h e n0

(rc rD a m b u la n te B e h a n d lrn g o h n e N u tz u n g k o m p le m e n ia re r E i n . i c h t u n s e n )u n d3(v o lls ta tio D ;re B e h a n d h n g )z rg e o rd n e t. W ie b e i a n d e r e nIn d iz e sa u c h w u

z w is c h e rIl u n d K o s te n b e t r ; i g t f n r d i e C e r a m t g r u p p ed e . 1 1 9 4 P r t i e n t e nund deng e , s a m l e n U D t e $ u c h u n g s z e j t r a ' l m 0 , 9 7(p < 0 , 0 0 1) . T a b . l z e i g t , d a s ss ic h ;h n lic h h o h e K o f f e l a t i o n e r a u c h e r g e b e n , w e n n e i n r e l n e U n te rg .u p p e nd e f P a tie n te n p o p u la tio nb e tra c h te tw e |d e r. A u c h w e n n s ic h d ie s e U n te rg ru p p e nh in s ic h tlic h d e . K o s te n b z w

d e s 1 ld e r tlic h v o n e in a n d e .u n te r s c h e id e n w ie z .B .E B t u D d w ie d \u20ac r a u in a h m e n, b le ib e nd o c h je w e ils h o h e K o r r e la tio n e nb e s te h e n .