J Valdés-Stauber1, S Bachthaler2. 1. Abteilung Psychiatrie und Psychotherapie I, Universität Ulm, Zentrum für Psychiatrie Südwürttemberg, Weingartshofer Straße 2, 88214, Ravensburg, Deutschland. juan.valdes-stauber@zfp-zentrum.de. 2. Abteilung für Psychosomatische Medizin und Psychotherapie, Ravensburg, Zentrum für Psychiatrie Südwürttemberg, Ravensburg, Deutschland.
Abstract
BACKGROUND: The investigation of the real density of care by a consultation-liaison service (CLS) as a function of patient groups, settings and diagnoses makes sense with respect to a better allocation of resources. OBJECTIVE: Are there differences concerning the density of care by a CLS in a general hospital depending on patient groups and on the psychiatric diagnosis? METHOD: A retrospective (2012-2015) survey of all consultations (n = 7081 corresponding to 4080 patients) was carried out based on the CLS documentation for quality assurance. Bivariate tests (i.e. χ2-test and ANOVA) and multivariate linear and logistic models were used to investigate group differences and associations. RESULTS: The number of consultations achieved corresponded to 3.2 % of the total admissions to hospital, especially internal medicine (22.3 %), surgery (26.1 %) as well as gynecology and obstetrics (21.1 %). A suicide attempt was the reason for treatment in 3.3 %. Each patient received on average 1.7 consultations lasting 75 min but only 25 % received 2 or more consultations. Patients with psychiatric comorbidities, non-oncology patients as well as female and young patients received a more intensive care by CLS. Patients with depressive and somatoform disorders received a higher density of treatment. DISCUSSION: The psychotherapeutic interventions performed did not follow the expected diagnostic patterns in other settings. Systemic interventions with indirect treatment should be given priority in older patients and especially in patients with organic mental disorders.
BACKGROUND: The investigation of the real density of care by a consultation-liaison service (CLS) as a function of patient groups, settings and diagnoses makes sense with respect to a better allocation of resources. OBJECTIVE: Are there differences concerning the density of care by a CLS in a general hospital depending on patient groups and on the psychiatric diagnosis? METHOD: A retrospective (2012-2015) survey of all consultations (n = 7081 corresponding to 4080 patients) was carried out based on the CLS documentation for quality assurance. Bivariate tests (i.e. χ2-test and ANOVA) and multivariate linear and logistic models were used to investigate group differences and associations. RESULTS: The number of consultations achieved corresponded to 3.2 % of the total admissions to hospital, especially internal medicine (22.3 %), surgery (26.1 %) as well as gynecology and obstetrics (21.1 %). A suicide attempt was the reason for treatment in 3.3 %. Each patient received on average 1.7 consultations lasting 75 min but only 25 % received 2 or more consultations. Patients with psychiatric comorbidities, non-oncology patients as well as female and young patients received a more intensive care by CLS. Patients with depressive and somatoform disorders received a higher density of treatment. DISCUSSION: The psychotherapeutic interventions performed did not follow the expected diagnostic patterns in other settings. Systemic interventions with indirect treatment should be given priority in older patients and especially in patients with organic mental disorders.
Entities:
Keywords:
Consultation and liaison psychiatry; General hospital; Psychiatric care; Psycho-oncology; Psychosomatic care
Authors: Sebastian Kreil; Teresa Biermann; Markus Weih; Johannes Kornhuber; Juan Manuel Maler; Wolfgang Sperling Journal: Psychiatr Prax Date: 2011-03-21