Independent Evaluation of a Cross-Sector Approach to the Health Care of People with Chronic Psychological Illness

Cross-sectional and longitudinal data analyses commissioned by Barmer GEK, Germany's biggest statutory health insurance provider, is currently being conducted to improve the health care of people with psychological illness, in accordance with Article 64b Volume V of the German Social Code. The Institute of Medical Sociology and Rehabilitation Science evaluates the pilot project on the basis of claims data obtained from the statutory health insurance providers at three points of measurement from 2014 to 2019. The target group is patients with chronic forms of schizophrenia, dementia, and depression. The aim of the pilot project is to ensure continuity of care for patients with serious chronic mental health disorders. The treatment provided is to be specific to the disorder, individualized, and appropriate to the phase of the illness, with the aims of reducing recurrence and relapse rates and shifting the focus of the treatment to the patient’s living environment. One acute problem is the underfunding of the outpatient sector; the treatment options available for patients with severe mental illness, in particular, are inadequate. Moreover, because the in- and outpatient sectors have distinct funding systems, there is little intersection between the two. This results in a lack of continuity of treatment, which in turn leads to increased admissions to inpatient care. The pilot project designed to address these deficits was initiated in 2014 in the St. Hedwig Clinics in Berlin.