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[Optimization of the work of outpatient memory clinics from the perspective of value-based healthcare-An approach from the Clinic for Psychiatry and Psychotherapy of the ZI Mannheim]
Hausner Lucrezia, Steinmetz Annika, Benson Gloria S, Kalla Milena, Schönberger Anna, Schild Ann-Katrin, Fehrenbach Sabrina, Knudsen Arne et al.. Der Nervenarzt, 2025-11-20
Topic: Risk, prevention and care in population studies
Value-based healthcare (VBHC) is a concept in health economics that aims to improve patient care through needs-oriented treatment approaches while considering the costs incurred. "Value" describes the ratio of patient-centered outcome and experience data to the costs incurred. To analyze and optimize the workflows of the Outpatient Memory Clinic of the ZI Mannheim according to VBHC criteria. The aim of the study was to improve the quality of care from the patient's perspective, to measure the changes in benefits for all involved parties and simultaneously to evaluate the costs and revenues of the diagnostic process. The initial diagnostic process was analyzed in 25 dyads (patient + caregiver) using standardized (State-Trait Anxiety Inventory (STAI), Patient Assessment of Chronic Illness Care (PACIC), Euroquol visual analogue scale (EQ-VAS)) and process-oriented questionnaires. After staff training, a modified diagnostic process (VBHC-M) was implemented in a pilot study. This process was then evaluated in a second survey of 17 dyads and 8 additional patients using the same questionnaires. The results from both surveys were compared using t‑tests or Mann-Whitney U tests. A cost and revenue analysis (CRA) was conducted using annual data. The quality of care (PACIC) for patients (p < 0.001) and caregivers (p = 0.004) improved following VBHC‑M, as did patient satisfaction and expectations (process-oriented questionnaires). The CRA showed that VBHC‑M resulted in a financial disadvantage for the care provider. The workflows of the outpatient memory clinic could be successfully optimized in the sense of patient-centered care, leading to an increased number of patients treated, higher patient and caregiver satisfaction and cost savings. This shows that VBHC can be implemented in outpatient memory clinics; however, the accelerated diagnostic process is reimbursed at a lower rate under the current flat-rate quarterly payment system, highlighting the need for adjustments to reimbursement models.
Key findings
- The results from both surveys were compared using t‑tests or Mann-Whitney U tests.
- The CRA showed that VBHC‑M resulted in a financial disadvantage for the care provider.
- This shows that VBHC can be implemented in outpatient memory clinics; however, the accelerated diagnostic process is reimbursed at a lower rate under the current flat-rate quarterly payment system, highlighting the need for adjustments to reimbursement models.
Why it matters
This study analyzed and modified the diagnostic workflow of an outpatient memory clinic using value-based healthcare criteria, finding improved quality of care but a financial disadvantage for the care provider. It concerns diagnostic process and reimbursement, not treatment, cure, or prevention.
Study details
- Evidence strengthLow
How this study scored 39/100
Published in a peer-reviewed journal. Scored zero for study design, sample size, effect reported, studied in people and randomised / blinded because the record does not state it. We have no data on journal's citation record, times cited, citations per year, impact for its field and year, still being cited, senior author's track record, institution's track record and multi-centre collaboration, so those were left out: it earned 25 of the 64 points we could judge it on, which is 39 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Der Nervenarzt) |
| Journal's citation record | — / 4 | No journal record from OpenAlex — left out of this score |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 5 / 5 | 2026 — within 1 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | — / 7 | No citation count (not found in OpenAlex) — left out of this score |
| Citations per year | — / 5 | No citation count or no year — left out of this score |
| Impact for its field and year | — / 6 | No field-weighted citation impact (OpenAlex has none yet) — left out of this score |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | — / 4 | No yearly citation counts — left out of this score |
| Senior author's track record | — / 4 | Senior author's record not available — left out of this score |
| Institution's track record | — / 3 | No institution listed in OpenAlex — left out of this score |
| Multi-centre collaboration | — / 3 | Institutions not listed — left out of this score |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 41263958) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Points | 25 / 64 | Scored on 12 of 20 parts. We have no data for the rest, so they are left out: 25 of the 64 points we could judge it on is 39 out of 100. |
| Total | 39 / 100 | — |
What each of these 20 components measures, and what this score is not →
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Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record's author list ends in “et al.”, so not every author is named. Check the citation against the original before you use it.
APA 7th
Lucrezia, H., Annika, S., Benson Gloria, S., Milena, K., Anna, S., Ann-Katrin, S., et al. (2026). [Optimization of the work of outpatient memory clinics from the perspective of value-based healthcare-An approach from the Clinic for Psychiatry and Psychotherapy of the ZI Mannheim]. Der Nervenarzt. https://doi.org/10.1007/s00115-025-01916-5
Vancouver
Lucrezia H, Annika S, Benson Gloria S, Milena K, Anna S, Ann-Katrin S, et al. [Optimization of the work of outpatient memory clinics from the perspective of value-based healthcare-An approach from the Clinic for Psychiatry and Psychotherapy of the ZI Mannheim]. Der Nervenarzt. 2026. doi:10.1007/s00115-025-01916-5. PMID: 41263958.
BibTeX
@article{lucrezia2026-41263958,
author = {Lucrezia, Hausner and Annika, Steinmetz and Benson Gloria, S. and Milena, Kalla and Anna, Schönberger and Ann-Katrin, Schild and Sabrina, Fehrenbach and Arne, Knudsen and others},
title = {{[Optimization of the work of outpatient memory clinics from the perspective of value-based healthcare-An approach from the Clinic for Psychiatry and Psychotherapy of the ZI Mannheim]}},
journal = {Der Nervenarzt},
year = {2026},
doi = {10.1007/s00115-025-01916-5},
pmid = {41263958},
url = {https://doi.org/10.1007/s00115-025-01916-5}
}
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