eprintid: 21576
rev_number: 13
eprint_status: archive
userid: 1589
dir: disk0/00/02/15/76
datestamp: 2016-07-22 12:27:37
lastmod: 2024-04-07 16:03:10
status_changed: 2016-07-22 12:27:37
type: article
metadata_visibility: show
creators_name: Bauer, E.
creators_name: Kleine-Budde, Katja
creators_name: Stegbauer, C.
creators_name: Kaufmann-Kolle, P.
creators_name: Götz, Katja
creators_name: Bestmann, B.
creators_name: Szecsenyi, Joachim
creators_name: Bramesfeld, A.
title: Structures and processes necessary for providing effective home treatment to severely mentally ill persons: a naturalistic study
subjects: ddc-610
divisions: i-910100
abstract: Background: Home treatment for severely mentally ill persons is becoming increasingly popular. This research aims to identify structures and processes in home treatment that impact on patient-related outcomes.   Methods: We analysed 17 networks that provide home treatment to severely mentally ill persons using a naturalistic approach. The networks were similar with regard to central components of home treatment such as case management, 24 h crisis hotline and home visits, but differed in all other aspects such as the multidisciplinary teams, time spent with patients, etc. To determine treatment outcome, patients’ psychosocial functioning was measured using the Health of the Nation Outcome Scales (HoNOS). Structures and processes were assessed using claims data and questionnaires answered by the different networks. Primary outcome was highlighted by the change in HoNOS scores from the start of home treatment compared with 6 months later. We sought to explain this outcome through patient and network characteristics using regression analysis. Data on 3,567 patients was available.   Results: On average, psychosocial functioning improved by 0.84 across networks between t0 and t1. There were more similarities than differences between the networks with regard to the structures and processes that we tested. A univariate regression analysis found staff’s prior experience in mental health care and the effort that they invested in their work correlated positively with patient outcome. This needs to be interpreted under considering that univariate analysis does not show causal relationship. A high case load per case manager, increased and longer patient contact and more family intervention were correlated with worse patient outcome, probably indicating that sicker patients receive more care and intervention.   Conclusion: Home treatment networks succeed in delivering care tailored to the needs of patients. In order to improve the quality of care in home treatment, this study suggests employing experienced staff who is ready to invest more effort in their patients. Further research needs to consider a longer follow-up time.
date: 2016
publisher: BioMed Central; Springer
id_scheme: DOI
ppn_swb: 1657876020
own_urn: urn:nbn:de:bsz:16-heidok-215763
language: eng
bibsort: BAUERESTRUCTURES2016
full_text_status: public
publication: BMC Psychiatry
volume: 16
number: 242
place_of_pub: London; Berlin; Heidelberg
pagerange: 1-9
issn: 1471-244X
citation:   Bauer, E. ; Kleine-Budde, Katja ; Stegbauer, C. ; Kaufmann-Kolle, P. ; Götz, Katja ; Bestmann, B. ; Szecsenyi, Joachim ; Bramesfeld, A.  (2016) Structures and processes necessary for providing effective home treatment to severely mentally ill persons: a naturalistic study.  BMC Psychiatry, 16 (242).  pp. 1-9.  ISSN 1471-244X     
document_url: https://archiv.ub.uni-heidelberg.de/volltextserver/21576/1/12888_2016_Article_945.pdf