[Impact of the PEPP reimbursement system and other developments on inpatient care of general psychiatry patients 2005 to 2022: a retrospective analysis].

Publication date: Jun 24, 2026

The traditional division of clinical psychiatry in Germany comprises general psychiatry, geriatric psychiatry and addiction medicine. It is important to know how factors such as age, gender, length of stay, comorbidities and concomitant medication have developed in these areas in order to understand future care needs. The billing system (abbreviated as “PEPP”) unique to Germany was introduced in 2018 and brought structural changes to psychiatric care. This study focuses on a retrospective, longitudinal observation in general psychiatry, describes developments, and examines the impact of the PEPP reimbursement system on length of stay and coding of diagnoses in general psychiatry. The Evangelische Stiftung Tannenhof operates a specialist hospital for psychiatry, psychotherapy, psychosomatics and neurology with a compulsory care area containing 580,000 inhabitants. Data from the hospital information system was analysed in a descriptive manner. A total of 61,385 inpatient cases from general psychiatry belonging to the ICD-10 diagnosis groups F2, F3, F4 and F6 were included. Demographic data, length of stay and the development of psychiatric main and somatic secondary diagnoses as well as medication prescriptions were analysed. The gender distribution and age structure in general psychiatry remained largely constant between 2005 and 2022. The number of cases increased continuously and the length of stay decreased continuously. The main diagnoses from the general psychiatry group remained relatively stable with the affective disorders group being the largest. The total number of psychiatric and somatic medications prescribed increased progressively, especially the share with somatic indications. During the COVID-19 pandemic, Z diagnoses were frequently assigned as secondary diagnoses. The retrospective analysis of patient data in general psychiatry between 2005 and 2022 shows that the age structure and main diagnoses have remained relatively stable. In contrast, the increase in the prescription of medication and somatic secondary diagnoses is an important development that emphasises the need for increased training and interdisciplinary collaboration in the care of psychiatric patients.

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Original Article