Patterns of referral from consultation-liaison to social work services.
Despite their importance, the nature and context of referral patterns among mental health disciplines in the general hospital has not been sufficiently explored. This study focuses on consultation-liaison (C-L) psychiatry patterns of referral to social work services (SWS). From a structured data base of 1170 consults, it was observed that C-L referred 24% of the cases seen by psychiatry. Psychiatry was more likely to refer those who are: female (p = less than 0.05), living with others (p = less than 0.05), described as less urgent (p = less than 0.05), diagnosed with personality disorders (p = less than 0.01), under greater psychosocial stress (Axis IV) (p = less than 0.001), and evaluated as having better functional status (Axis V) (p = less than 0.001). Regression analysis revealed that four variables had the greatest impact on differentiating those C-L referred to SWS from the "others": 1) constant observation recommended (log -586, p = 0.0001); 2) type of psychiatric management (log -573, p = 0.0001); 3) Medicaid insurance (log -564, p = 0.0001); and 4) original referral for the consultation was the refusal of tests or medical treatment (log -559, p = 0.002).
Strain
J J
JJ
Department of Psychiatry, Mount Sinai School of Medicine, New York, NY 10029.
Gise
L H
LH
Fulop
G
G
Strain
J J
JJ
Hammer
J S
JS
D001008:Anxiety Disorders / Q000175:diagnosis / Q000628:therapy; D015331:Cohort Studies; D003866:Depressive Disorder / Q000175:diagnosis / Q000628:therapy; D006746:Hospital Bed Capacity, 500 and over; D006801:Humans; D015274:Interdepartmental Relations; D007400:Interprofessional Relations; D019965:Neurocognitive Disorders / Q000175:diagnosis / Q000628:therapy; D009519:New York City; D010348:Patient Care Team; D010554:Personality Disorders / Q000175:diagnosis / Q000628:therapy; D011567:Psychiatric Department, Hospital / Q000706:statistics & numerical data*; D011613:Psychotherapy; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D012307:Risk Factors; D012803:Sick Role; D012948:Social Work Department, Hospital / Q000706:statistics & numerical data*; D012949:Social Work, Psychiatric / Q000706:statistics & numerical data*