Heavy user psychiatrischer Versorgungsdienste

Zusammenfassung

Anliegen: Die Arbeit gibt einen Überblick über Erkenntnisse und Probleme der Heavy-user-Forschung. Methode: Dazu wurden deutsch- und englischsprachige Publikationen zum Thema „heavy user” und zu relevanten Grenzgebieten analysiert. Ergebnisse: Heavy user sind Patienten, die einen überdurchschnittlich hohen Anteil medizinischer Versorgung konsumieren. Die Merkmale dieser Patienten sind inhomogen. Soziale Probleme, Krankheitsverleugnung, Noncompliance und begleitende Persönlichkeitsstörungen sowie Substanzmissbrauch treten gehäuft auf. Künftige Untersuchungen müssen heavy use krankheitsspezifisch definieren und klären, ob die starke Inanspruchnahme bestimmter Dienste der Situation der Patienten angemessen ist. Schlussfolgerungen: Heavy user sollten frühzeitig identifiziert werden, um ihnen Versorgungsalternativen anbieten zu können, die ihren Problemen besser gerecht werden und die inadäquat starke Inanspruchnahme kostenintensiver Leistungen überflüssig machen.

Abstract

Objective: This paper reviews findings and problems of heavy users research. Methods: The German- and English language literature about „heavy users” and relevant border areas was analyzed. Results: Heavy users are patients who consume a disproportionate share of medical services. The characteristics of heavy users are inhomogeneous. Social problems, denial of illness, non-compliance, comorbid personality disorders and substance misuse contribute significantly to heavy use. Future studies should define heavy use illness-related. More research is needed to clarify whether heavy use of special services is adequate to the patients situation. Conclusions: Heavy users should be identified early, in order to offer them alternative services, which better fulfil the patients specific conditions and prevent an inadequate heavy use of expensive services.

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