Consultation outcomes. The psychiatrist as consultee.

The frequent coexistence of psychiatric and medical illness supports the need for excellent medical care on inpatient psychiatric services. Effective use of consultation is an important element in ensuring this care. In our study of medical-surgical consultation to an inpatient psychiatric service during a two-year period, outcome variables, such as frequency of and concordance with drug and diagnostic action recommendations, were determined and compared with similar data for psychiatric consultations to medical-surgical services. Thirty-eight percent of cases received a consultation. Patients seen by a consultant had a longer hospital stay. Twenty-seven and forty-six percent of consultantions contained a drug or a diagnostic action recommendation, respectively. The concordance of psychiatric consultees was 79% for drugs and 75% for diagnostic action recommendations. Comparison with medical-surgical consultations done by psychiatric consultants revealed important important differences and similarities.