Ärztlicher Personalbedarf in der Versorgungspsychiatrie – eine „Bottom-Up“ Personalbedarfsberechnung am Beispiel der Psychiatrischen Abteilung des Donauspitals in Wien

Fischer, Peter; Hanak, Sören; Wally, Beate; Aigner, Martin

doi:10.1007/s40211-016-0170-5

Cited by 7 publications

(3 citation statements)

References 20 publications

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“…Regarding mental health care or psychosocial care, the main barriers mentioned in the literature range from stigmatisation, information deficits, and waiting times among people with mental health problems (cf. [27]) to barriers to accessing psychotherapy as well as psychiatric inpatient care and psychiatric care in hospital outpatient departments [20,[27][28][29][30][31][32][33][34][35][36]. Previous studies have identified financial barriers to accessing psychotherapy, often in combination with other barriers such as long-term unemployment, risk of social exclusion, or language barriers [29][30][31][32].…”

Section: Introductionmentioning

confidence: 99%

Barriers to accessing health care for people with chronic conditions: a qualitative interview study

Schwarz¹,

Schmidt

Bobek

et al. 2022

BMC Health Serv Res

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Background There is a growing interest in redesigning healthcare systems to increase access to and coordination across care settings for people with chronic conditions. We aim to gain a better understanding of the barriers faced by (1) children with chronic bronchial asthma, (2) adults with non-specific chronic back pain, and (3) older people with pre-existing mental illness/es in Austria’s fragmented social health insurance system. Methods Using a qualitative design, we conducted semi-structured interviews face-to-face and by telephone with health service providers, researchers, experts by experience (persons with lived/ personal experience, i.e., service users, patient advocates or family members/carers), and employees in public health administration between July and October 2019. The analysis and interpretation of data were guided by Levesque’s model of access, a conceptual framework used to evaluate access broadly according to different dimensions of accessibility to care: approachability, acceptability, availability and accommodation, affordability, and appropriateness. Results The findings from the 25 expert interviews were organised within Levesque’s conceptual framework. They highlight a lack of coordination and defined patient pathways, particularly at the onset of the condition, when seeking a diagnosis, and throughout the care process. On the supply side, patterns of poor patient-provider communication, lack of a holistic therapeutic approach, an urban-rural divide, strict separation between social care and the healthcare system and limited consultation time were among the barriers identified. On the demand side, patients’ ability to perceive a need and to subsequently seek and reach healthcare services was an important barrier, closely linked to a patient’s socio-economic status, health literacy and ability to pay. Conclusions While studies on unmet needs suggest a very low level of barriers to accessing health care in the Austrian context, our study highlights potential ‘invisible’ barriers. Barriers to healthcare access are of concern for patients with chronic conditions, underlining existing findings about the need to improve health services according to patients’ specific needs. Research on how to structure timely and integrated care independent of social and economic resources, continuity of care, and significant improvements in patient-centred communication and coordination of care would be paramount.

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Section: Introductionmentioning

confidence: 99%

Barriers to accessing health care for people with chronic conditions: a qualitative interview study

Schwarz¹,

Schmidt

Bobek

et al. 2022

BMC Health Serv Res

View full text Add to dashboard Cite

show abstract

“…Regarding mental health care or psychosocial care, the main barriers mentioned in the literature range from stigmatisation, information de cits, and waiting times among people with mental health problems (cf. [26]) to barriers to accessing psychotherapy as well as psychiatric inpatient care and psychiatric care in hospital outpatient departments [19,[26][27][28][29][30][31][32][33][34][35]. Previous studies have identi ed nancial barriers to accessing psychotherapy, often in combination with other barriers such as long-term unemployment, risk of social exclusion, or language barriers [28][29][30][31].…”

Section: Barriers For People With Chronic Conditions In Austriamentioning

confidence: 99%

Barriers to Accessing Health Care for People with Chronic Conditions: A Qualitative Study

Schwarz

Schmidt

Bobek

et al. 2021

Preprint

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Background: There is a growing interest in redesigning healthcare systems to increase access to and coordination across care settings for people with chronic conditions. We aim to promote patient-centredness by gaining a better understanding of the barriers faced by (1) children with chronic bronchial asthma, (2) adults with non-specific chronic back pain, and (3) older people with pre-existing mental illness/es while addressing the problem of fragmentation in Austria’s healthcare system.Methods: Using a qualitative design, we conducted semi-structured interviews face-to-face and by telephone with health service providers, researchers, experts by experience (e.g., patient advocates, family members/carers), and employees in public health administration between July and October 2019. The analysis and interpretation of data were guided by Levesque’s model of access, a conceptual framework used to evaluate access broadly according to five dimensions of accessibility to care: approachability, acceptability, availability and accommodation, affordability, and appropriateness.Results: The findings from the 25 expert interviews were organised within Levesque’s conceptual framework in four dimensions of barriers. They highlight the lack of coordination and defined patient pathways, particularly at the onset of the condition, when seeking a diagnosis, but also later on. Barriers related to issues such as geography (e.g., longer distances and travel times as well as fewer healthcare services in remote rural regions), coordination of care (e.g., structural barriers and inconsistent care pathways), socioeconomic status (e.g., the ability to pay for healthcare services but also basic health literacy), and comorbidity (e.g., consideration of the patients’ state of mental health and holistic therapy approaches).Conclusions: Barriers to healthcare access are of particular concern for patients with chronic conditions, resulting in an urgent need to improve health services according to patients’ specific needs. For health services to be properly accessible, timely and integrated care independent of social and economic resources, continuity of care, and significant improvements in patient-centred communication and coordination of care are paramount. This study has important implications for policy and practice as it highlights provider, expert, and researcher perspectives on access to the healthcare system in Austria and offers a broader look at the changes required by stakeholders in the future.

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“…Dass die Personalausstattung in Deutschland nach den gesetzlichen Vorgaben angesichts vielfältig gestiegener Aufgaben vor allem in der Dokumentation und kontinuierlich gestiegener Aufnahmezahlen grenzwertig knapp ist und zu impliziten Rationierungen führt, ist gut bekannt [19]. Gerade in der Psychiatrie bedürfte eine qualitativ hochwertige und nach humanen Gesichtspunkten geführte Patientenarbeit einer personellen Ausstattung, von der wir sowohl in Deutschland wie auch in Österreich weit entfernt sind [20]. Einen einfachen linearen Zusammenhang zwischen der Personalausstattung in der Pflege und der Öffnung psychiatrischer Stationen zu postulieren, greift freilich sicher zu kurz [16].…”

Section: Diskussionunclassified

Wie können psychiatrische Kliniken in Österreich vollständig offen geführt werden?

Steinert

Scharfetter

2018

Psychiat Prax

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Ärztlicher Personalbedarf in der Versorgungspsychiatrie – eine „Bottom-Up“ Personalbedarfsberechnung am Beispiel der Psychiatrischen Abteilung des Donauspitals in Wien

Abstract: Severely ill psychiatric patients seem to be undertreated because of low staffing of psychiatric departments.

Cited by 7 publications

References 20 publications

Barriers to accessing health care for people with chronic conditions: a qualitative interview study

Barriers to accessing health care for people with chronic conditions: a qualitative interview study

Barriers to Accessing Health Care for People with Chronic Conditions: A Qualitative Study

Wie können psychiatrische Kliniken in Österreich vollständig offen geführt werden?

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