Autoren:	Singer, Susanne Engesser, Deborah Wirp, Bernhild Lang, Klaus Paserat, Anke Kobes, Jörg Porsch, Udo Mittag, Martina Taylor, Katherine Gianicolo, Emilio Maier, Lena
Titel:	Effects of a statutory reform on waiting times for outpatient psychotherapy : a multicentre cohort study
Online-Publikationsdatum:	16-Jan-2023
Erscheinungsdatum:	2022
Sprache des Dokuments:	Englisch
Zusammenfassung/Abstract:	Aims: Social inequality in access to mental health care is a current concern across the world. The authors determined whether differences in waiting times for outpatient psychotherapy changed after a statutory reform of the German psychotherapy law. Methods: The dates of first contact, first visit and treatment start, along with socio demographic and clinical data, were extracted from patient records in community based psychotherapy practices. Predictors of waiting times for first visit and treatment start were investigated using multilevel Cox regression models to estimate adjusted hazard ratios (HRadj). Results: Data from 1548 patient records from nine practices were extracted. Before the reform, the time span between first contact and first visit was longer for patients with compulsory education than for patients with a college degree (HRadj 0.8, 95% CI 0.6–1.0), whereas this was no longer the case after the law changed (HRadj 1.0, 95% CI 0.8–1.3). Patients whose treatment was covered by the state were at higher risk of a long waiting time from last visit to treatment start compared with patients with statu tory health insurance after the law changed (HRadj 0.4, 95% CI 0.3–0.7), which had not been the case before the law changed (HRadj 1.3, 95% CI 0.8–2.2). Conclusions: Social inequality in access to psychotherapy was reduced in part by the updated psychotherapy law in terms of educational groups; however, it increased in other aspects. This shows how political decisions can powerfully impact clinical prac tice, ultimately helping one group of patients while disadvantaging another.
DDC-Sachgruppe:	610 Medizin 610 Medical sciences
Veröffentlichende Institution:	Johannes Gutenberg-Universität Mainz
Organisationseinheit:	FB 04 Medizin
Veröffentlichungsort:	Mainz
ROR:	https://ror.org/023b0x485
DOI:	http://doi.org/10.25358/openscience-8573
Version:	Published version
Publikationstyp:	Zeitschriftenaufsatz
Nutzungsrechte:	CC BY-NC-ND
Informationen zu den Nutzungsrechten:	https://creativecommons.org/licenses/by-nc-nd/4.0/
Zeitschrift:	Counselling and psychotherapy research 22 4
Seitenzahl oder Artikelnummer:	982 997
Verlag:	Wiley
Verlagsort:	Chichester
Erscheinungsdatum:	2022
ISSN:	1746-1405
DOI der Originalveröffentlichung:	10.1002/capr.12581
Enthalten in den Sammlungen:	DFG-491381577-H