Article
Indicators of change in mental health care during the first year of the COVID-19 pandemic in Germany
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Authors
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Fabian Baum
- Zentrum für Evidenzbasierte Gesundheitsversorgung (ZEGV), Medizinische Fakultät und Universitätsklinikum Carl Gustav Carus der Technischen Universität Dresden, Dresden, Deutschland
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Jochen Schmitt
- Zentrum für Evidenzbasierte Gesundheitsversorgung (ZEGV), Medizinische Fakultät und Universitätsklinikum Carl Gustav Carus der Technischen Universität Dresden, Dresden, Deutschland
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Josephine Jacob
- InGef – Institut für angewandte Gesundheitsforschung Berlin GmbH, Berlin, Deutschland
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Klaus Lieb
- Klinik für Psychiatrie und Psychotherapie, Universitätsmedizin Mainz, Mainz, Deutschland
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Hauke Felix Wiegand
- Klinik für Psychiatrie und Psychotherapie, Universitätsmedizin Mainz, Mainz, Deutschland
| Published: | October 2, 2023 |
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Outline
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Background and state of research: In many regions of the world the COVID-19 pandemic went along with a significantly reduced utilization of both inpatient and outpatient mental health services. Surveys and routine-data studies from specific provider networks hinted at similar trends for the German mental health care system.
Research question and objectives, hypothesis: The study, which was developed within the NUM egePan and PREPARED projects, aimed at comprehensively and systematically quantizing changes in the utilization of psychiatric, psychiatric-pharmacotherapeutic and psychotherapeutic services in the German inpatient and outpatient mental health care system.
Method: Health insurance funds routine data from January 2016 to April 2021 from AOK plus and BKK with 8.8 million insured individuals was used for time series models, comparing pre-intervention (January 2016 to February 2020) to lockdown phases (March 2020 and December 2020) periods.
Results: The number of inpatient hospital admissions decreased by 24-28% in both lockdown periods. Admissions in the day clinic care setting decreased even further with a range of 44-61%. In the outpatient sector, the data showed a significant reduction in the number of incident outpatient diagnoses by 22% and 14%, respectively, in the two lockdown phases, whereas the volume of prescriptions of psychopharmacological substances stayed constant.
Discussion: Survey results relate the significant changes in utilization in the inpatient sector and of incident diagnoses in the outpatient sector to hygiene and protection measures and health policy measures like funding for keeping inpatient capacities unoccupied and to a lesser degree changed patient behaviors.
Implication for care: It is problematic that in the pandemic profound health policy measures that were probably related to significant changes in utilization were performed without a surveillance of indicators of mental health care system utilization. A mental health care system surveillance should be established.
Funding: Individual funding (BMG, DRV, BMBF, DFG, etc); FK 01KX2021
