OBJECTIVES: The development of the burden of psychiatric diseases is essential for planning purposes of health policy makers. In the CEPHOS-LINK (FP7-project; No-603264), several strategies were incorporated to analyse psychiatric re-hospitalisations. Three research questions were defined: Change of re-hospitalisations in the future, Theoretical improvement of structure of care on a NUTS3-level, Possible impact of rising diabetes prevalence.

METHODS: We used an agent-based approach from the Generic Population Concept (GEPOC), developed in DEXHELPP (FFG, No-843550). The implemented Python framework was extended by several modules for each question. The modules for the other two questions are exchangeable or used together. The parameterization for AT/SL/Veneto was calibrated by pooled claims.

RESULTS: The results represents an average values out of ten simulation runs to minimize stochastic effects. Pathways of simulated patients are available on microscopic level, meaning that they can be followed over time. For the macroscopic evaluations events of the patients are aggregated up to year 2039 for different patient characteristics. The outcomes show an increase in both index- and re-hospitalisation rates, especially for females and patients with psychotic diagnoses. Looking at NUTS3 regions with highest average driving time to hospitals a change to optimised care can lower the re-hospitalisation rate by nearly 39% in AT, about 20% in SL and in Veneto with actual lowest distance to service only 7.5%. In case of diabetes it has to be noticed that the demographic changes are effecting especially prognosis for AT.

CONCLUSIONS: All three scenarios show that psychiatric hospitalizations are rising, especially in Austria and Veneto region. The most drastic changes can be assumed to come in the timeframe of the next 10 years for non-psychotic diagnosis. Changing diabetes prevalence also has an impact on psychiatric patients’ re-hospitalisation and shows that comorbidities should not be neglected when analysing future development of re-hospitalisation rates.