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Klin Padiatr 2016; 228(04): 195-201
DOI: 10.1055/s-0042-102787
Originalarbeit
© Georg Thieme Verlag KG Stuttgart · New York

Konzeptanalyse einer stationären und ambulanten psychosozialen familienzentrierten Betreuung in der Neonatologie in Zeiten des G-BA-Beschlusses

Analysis of a Family-centred Care Programme with Follow-up Home-visits in Neonatology – In Times of the Directive from G-BA
B. M. Hüning
1   Department of Neonatology, University Children’s Hospital Essen, Essen
2   Elternberatung „Frühstart“/Bunter Kreis, University Hospital Essen, Essen
,
M. Reimann
2   Elternberatung „Frühstart“/Bunter Kreis, University Hospital Essen, Essen
,
S. Sahlmen
2   Elternberatung „Frühstart“/Bunter Kreis, University Hospital Essen, Essen
,
S. Leibold
2   Elternberatung „Frühstart“/Bunter Kreis, University Hospital Essen, Essen
,
J. C. Nabring
3   University Hospital Controlling, Essen, Essen
,
U. Felderhoff-Müser
1   Department of Neonatology, University Children’s Hospital Essen, Essen
› Author Affiliations
Further Information

Publication History

Publication Date:
04 April 2016 (online)

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Zusammenfassung

Hintergrund: Die Versorgung Frühgeborener (FG) hat sich in den letzten Jahrzehnten durch einschneidende medizinische Fortschritte, aber auch auf dem Sektor psychosozialer Betreuung stark gewandelt. Mit dem G-BA-Beschluss erkennt die Politik die Notwendigkeit familienzentrierter Betreuung an.

Ziel der Untersuchung: Notwendige zeitliche und personelle Ressourcen an einem Zentrum mit etablierter sektorübergreifender Betreuung zu evaluieren.

Methodik: Die Elternberatung/Bunter Kreis betreut FG und kranke Neugeborene (NG) von der Risikoschwangerschaft bis nach Hause mit demselben interdisziplinären Team. Konzeptanalyse (2011–2014): 1.) Entwicklung der Fallzahlen/ Inanspruchnahme des Betreuungsangebotes 2.) zeitliche Ressourcen, 3.) personelle Ressourcen, 4.) Finanzierung, 5.) ökonomische Auswirkungen.

Ergebnisse: Vom 1.1.2011–31.12.2014 wurden 441 Fälle (2212 vollstationäre Fälle) beraten. Die Inanspruchnahme durch Familien sehr kleiner FG lag im Mittel (MW) bei 92% (86,4–97,2%). Der zeitliche Aufwand ist bei Kindern mit angeborenen Fehlbildungen am höchsten: Median 13,8 Stunden (h), sehr kleine FG: 11,2 h. Entlassung und ambulante Betreuung beanspruchen die meiste Zeit: Median 7,3 (0–42,5) h. Mit MW 3,1 Vollzeitpflegekräften (mehrere Teilzeitkräfte), können MW 48 Familien/Quartal betreut werden. Komplexe Fälle wurden durch Krankenkassen teilfinanziert (erfolgreiche Anträge sozialmedizinische Nachsorge: MW 92,7 (79,6–97,7)%).

Schlussfolgerung: Die psychosoziale Betreuung sehr kleiner Frühgeborener wird gut von den Eltern angenommen und liegt zeitlich in einem überschaubaren Rahmen.

Abstract

Background: Marked progress in neonatology changed care of very preterm infants (VLBW) over the last decades – but also the attitude towards family-centred care (FCC). With the directive of the German Federal Joined Committee (G-BA), politicians recognize the necessity of neonatal FCC.

Aim: To evaluate time and personnel costs necessary at a centre of established FCC.

Methods: Elternberatung „Frühstart“ is a FCC programme for VLBW and seriously ill neonates from preganancy at risk to follow-up home-visits delivered by one interdisciplinary team. Analysis (2011–2014): 1.) Number of cases /participation in programme, 2.) resources of time, 3) and personnel, 4.) funding, 5) economic impact.

Results: 1.1.2011–31.12.2014: 441 cases (total cases: 2 212) participated in the programme. Participation of VLBW: mean 92% (86.4–97,2%). Costs of time are highest in neonates with congenital malformations: median 13.8 h, VLBW: median 11,2 h. Transition to home is most time intensive: median 7,3 (0–42.5) h. In average of 3.1 full-time nurses (part-time workers) are able to counsel 48 families/quarter. In severe cases funding is partly provided by health care insurances for social medical aftercare: positive applications: mean 92.7% (79.6–97.7%).

Conclusion: Participation in the FCC programme in neonatology is high and costs of time are manageable.

Schlüsselwörter

Familienzentrierte Betreuung - stationäre psychosoziale Betreuung - sozialmedizinische Nachsorge - Frühgeborene - G-BA-Beschluss

Key words

family-centre care - psychosocial support - social medical aftercare - preterm infants - directive of G-BA
 

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