ABSTRACT
BACKGROUND: The German Law for the Development of Care and Funding for Psychiatric and Psychosomatic Services (PsychVVG) has established a new regulation for the mental healthcare system. In the future, characteristics of hospitals and catchment areas will be an elementary part of negotiations on remuneration. OBJECTIVE: The aim of this study was to identify structural and regional characteristics of psychiatric hospitals in Germany that contribute to increased average costs according to the views of clinical managers and directors. METHODS: In this study 37 guided expert interviews were conducted with business managers, financial controllers, leading medical and nursing personnel from psychiatric hospitals and the characteristics relevant for the budget and increased average costs were collated. RESULTS: Important factors with top priority were hospital infrastructure, characteristics of the catchment area and specialties of inpatient services provided. Obligatory service for a defined catchment area, increased documentation requirements and infrastructure of buildings and grounds were estimated as being associated with the highest additional financial expenditure. CONCLUSION: It is a challenge for clinics to prove increased average costs due to the respective hospital structural and regional characteristics. This study shows which characteristics should be considered as most cost-relevant from the perspective of hospital management.
