Peter Potthoff - Böcker

Since the early 1970s, delivery of care to people who are consid- ered to suffer from chronic psychotic disturbances has been at a crossroads. In 1983, the European Regional Office of the World Health Organization (WHO), within its health economics pro- gramme, encouraged international research on the economic impli- cations of alternative strategies of care for those patients. Origi- nally, it was intended to compare at least two or more strategies of managing chronic psychotics, especially strategies which place dif- ferent emphasis on inpatient and outpatient care.Instead of designing a fully coordinated, multinational, multi- centre study based on a mutually agreed on study protocol, we de- cided on the following: - To meet with researchers interested in the social, psychological, and economic features of health care for chronic psychotic pa- tients - To stimulate ongoing research projects or to initiate new ones - To discuss quite different approaches from international and - terdisciplinary points of view - To review and revise the diversified end products of such an open research process For this purpose, we outlined a broad range of topics which could be included in the study: - Methodological problems of evaluation in this field - Social and economic implications of psychiatric deinstitutiona- zation - Scenarios of various degrees of deinstitutionalization - Assessment of (hospital) costs of the treatment for chronic sc- zophrenic and other psychotic patients - Public and private costs of the main treatment strategies - Time-expenditure analyses of chronic psychotic patients

R. Leidl, P. Potthoff, and D. Schwefel Health is a most vital resource represented in the degree of our well-being and our ability to conduct active and satisfactory lives. Acute and chronic illnesses diminish such well-being and abilities and may require resources for medical or nursing care. The improvement in health status, a major objective of health policy, requires the measurement of the severity of diseases and their consequences as essential elements of information. In application, the measurement approaches are gaining in relevance as they become more feasible and as more experience is gathered about their implementation and utilization. The feasibility of these new information tools is supported by developments in data processing technologies that permit broadly based empirical applications. Wider applications lead to improvements in the management use of this information. At the European level, better indicator systems of diseases and their various aspects are facing an increasing demand for patient-based health and health system comparisons and analyses. The measurement of health status and its implications can comprise a number of dimensions: various concepts of health and disease, types of diseases, methodological approaches of measurement, purposes of application and states of implementation.