[Quality characteristics and relevance to care of psychodynamic training outpatient clinics:The QVA Project].

Abstract

Introduction: Quality assurance (QA) in outpatient psychotherapy is currently undergoing a process of change. Hitherto, QA has been conducted by means of an expert review procedure (the so-called "Gutachterverfahren"), inter- and supervision as well as further mandatory training. Data-based QA systems have been increasingly discussed in recent years. On behalf of the G-BA, the IQTIG has recently published a draft of a legally binding QA procedure, which has, however, raised substantial concerns and resistance. Design: TheQVA project has two objectives. First, it provides participating training outpatient clinics with a data-driven QA system that enables an automated and risk-adjusted overall evaluation based on relevant patient and referral parameters. Second, the data is used to conduct research on important issues regarding the relevant psychotherapeutic care provided by outpatient clinics. Results: Since the start of data collection in 2022, n = 2058 patients have been recruited so far (March 2023), and a complete baseline diagnostic report has been generated for n = 1112 patients. The cross-sectional analyses of all patients assessed so far show a high burden of depression, interpersonal problems and impaired quality of life with severe impairment of personality functions, pronounced conflict diagnosis and high utilization of inpatient and day hospital treatments. Discussion: This paper describes an easy-to-implement data-based QA system for psychodynamic training outpatient clinics, while at the same time allowing for the examination of healthcare- relevant questions in a large sample. The first experiences show that the system works technically stable and was well-received by the participating outpatient clinics.