Zusammenfassung:
Die Zusammenarbeit niedergelassener Ärzte mit der psychiatrischen Klinik fand in Deutschland bislang wenig wissenschaftliches Interesse. Im Rahmen der Qualitätssicherung der psychiatrischen Versorgung gewinnt die Erfassung der sog. Nutzerzufriedenheit aber zunehmend an Bedeutung. In der vorliegenden Arbeit werden die Daten angloamerikanischer Studien in Zusammenschau mit den Ergebnissen einer eigenen Befragung von niedergelassenen Allgemeinärzten und Nervenärzten zu ihren Erwartungen an die psychiatrische Klinik dargestellt. Ein wesentlicher Problembereich bei der Zusammenarbeit ist die Überweisung psychisch Kranker in die psychiatrische Klinik. Für das Überweisungsverhalten der niedergelassenen Ärzte sind neben soziodemographischen und erkrankungsbedingten Patientenvariablen auch Einstellungen des einweisenden Arztes und seine psychiatrische Kompetenz sowie Einflüsse der psychiatrischen Klinik wie Wartezeiten, Kommunikation und Behandlungskompetenz von Bedeutung. Eine konstruktive Zusammenarbeit an der Schnittstelle zwischen ambulanter und stationärer Behandlung im Sinne einer funktionellen Vernetzung ist in Zeiten zunehmender Diversifikation des Versorgungsangebotes zur Verbesserung der Behandlungskontinuität psychisch Kranker notwendig.
Co-operation of physicians in private practice with psychiatric hospitals was investigated in Germany scarcely until now, although evaluation of consumer satisfaction is of great importance to quality assurance in psychiatry. In this paper, findings from previous studies are presented together with data from interviews with general practitioners and psychiatrists, evaluating their expectations regarding psychiatric hospitals. Substantial problem area in collaboration is referral to the psychiatric hospital. Apart from sociodemographic and disease-related variables, referral practice depends on referring physician's attitudes and competence in psychiatry, and provider influences like delay of admission, communication with referring physician, and competence of the hospital. As conclusion, constructive collaboration must be developed at the interface of outpatient and inpatient care. On account of increasing diversification of psychiatric services, functional network should be an ongoing goal to improve treatment continuity of patients with mental disorders.
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Dr. med. Hermann Spießl
Bezirksklinikum Regensburg
93042 Regensburg
