The Regional Psychiatry Budget: Costs and Effects of a New Multisector Financing Model for Psychiatric Care

Objective To evaluate a new multi-sector financing model for psychiatric care based on the capitation principle (Regional Psychiatry Budget, RPB). Methods Patients with a diagnosis according to ICD-10 F10, F2 and F3 were interviewed in the model region (MR, N = 258) and a control region (CR, N = 244) financed according to the fee-for-service principle. Effectiveness of care was assessed before RPB-introduction and after 1.5 years. Use of care was determined semi-annually. Results Costs of inpatient psychiatric treatment decreased more strongly in the MR, while hospital based outpatient care and day clinic treatment were intensified in comparison to the CR. Quality of life, severity of illness and illness-specific symptoms in patients improved similarly in MR and CR. The functional level improved more in the MR than in the CR, which was especially evident in schizophrenia patients. Conclusions Inpatient psychiatric care costs can be reduced with the RPB without compromising the quality of care.