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Treatment Data Collection in Germany

Treatment Data Collection in Germany. Dr. Tim Pfeiffer-Gerschel, Dipl. Psych., PPT. Legal Framework. German system of care for SUD. General Practitioners , MDs General Hospitals, ER Psychiatric Clinics Low threshold units Treatment centres ( counseling , treatment )

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Treatment Data Collection in Germany

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  1. Treatment Data Collection in Germany Dr. Tim Pfeiffer-Gerschel, Dipl. Psych., PPT

  2. Legal Framework

  3. German systemofcarefor SUD General Practitioners, MDs General Hospitals, ER PsychiatricClinics Low thresholdunits Treatment centres (counseling, treatment) „Interfaces“ between in-/outpatienttreatment (e.g. adaptation) SpecialisedClinics (Focus on Rehabilitation) Variouspartners

  4. German Treatment System Medical system „Specialised Treatment“ Rehabilitation General Practitioners, MDs General Hospitals, ER PsychiatricClinics Low thresholdunits Treatment centres (counseling, treatment) „Interfaces“ between in-/outpatienttreatment SpecialisedClinics (Focus on Rehabilitation) Various „cultures“

  5. German Treatment System Medical system TDI „Specialised Treatment“ Rehabilitation General Practitioners, MDs General Hospitals, ER PsychiatricClinics Low thresholdunits Treatment centres (counseling, treatment) „Interfaces“ between in-/outpatienttreatment SpecialisedClinics (Focus on Rehabilitation) Various „cultures“

  6. German treatmentsystem(Verysimplified) Additional funds(e.g. studies) Local/Regional Government Mixed financingscheme Pension Funds Health Insurance WelfareOrganisations Variousfundingsources

  7. Varioussources of information Available Hospital dischargeregister Statistics of national pensionfunds Healthinsurancestatistics (numerous…) Other… (e.g. long-lasting national studies) Main limitations Not connectedtoeachother Links verydifficulttoestablish (dataprotection)

  8. Currentsystem Based on broadconsensusamongpartners Core datasetbecamemandatorypartofreportingembedded in varioussystems (fundinglinkedtocompatibilitywithcoredataset) Large workinggroupestablishedmanyyearsago, involving all relevant partners (healthinsurance, federalstates, national MoH, treatmentorganisations, ...) Main aim: Toserve individual, regional and national needs, ensuring a commondenominator

  9. Core dataset

  10. Information collected on centrelevel European dataset (TDI) Additional information National dataset (KDS)

  11. Network ofreportinginstitutions

  12. Manyyearsago...

  13. Once upon a time... Since1978developmentof a commondatasetforreporting SUD treatment/counseling Model projectfundedbyMoH Content: Information necessaryfortrendanalysesandtomeasureperformanceofparticipatingcentres („Bundesdatensatz“) Increasingpressure on centres not participating in national reportingbetween 1995 and 2000; parallel: developmentof TDI 2.0

  14. Once upon a time... But:Noconsensusbetweenregardingcontentofthe national dataset(„performanceindicators“, toocomplex, toomanyitems) Action taken in 2000 todevelop a national coredataset 1998 firstitemset (clients), 1999 itemset (centres), 2000 (national tables) 2007: New national itemsetfollowing a multi-disciplinaryrevisionprocess

  15. Development since 2000 – Outpatient

  16. Development since 2000 - Inpatient

  17. Participationbycentre type

  18. Reporting (back)

  19. Onlinereport, focusedreports

  20. Other….

  21. www.suchthilfestatistik.de

  22. Technical Issues

  23. Software solutions - certification

  24. ID Coding, double-counting Analysis of aggregateddataon national levelonly – no individual data BUT: Regional solutionswithinterestingandevenmore „relevant“ outcome NO controlfor double-countingbeyondcentre (national statistics)

  25. Summary

  26. Limitations Aggregateddata German medicalsystemstrictlyfollows ICD-codingsystem „Static“ data (someitemsmeasuredatbeginningoftreatment, somatthe end – onlyveryfewtwiceandnoitemsillustratingchanges) Many different interestsandfundingschemes No national lawnormandatorysystemforparticipation Resultofnegotiationsbetween all partiesinvolved Large varietyof regional orevenlocaladaptationsandinterests

  27. Strengths Long datahistory Inclusiveapproach Large numberofepisodesreported Possibilitytobuildup „indirect“ pressure „Reference“ fordocumentation Verydetailedinformationavailable (compared e.g. tomedicaldocumentation) Wellestablishedstructures High flexibilitybelow national level

  28. Thankyouverymuchforyourattention! Dr. Tim Pfeiffer-Gerschel IFT Institut für Therapieforschung Parzivalstraße 25, D-80804 München Tel.: 089 – 36 08 04 40 pfeiffer-gerschel@ift.de

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