title: Patterns of referral from consultation-liaison to social work services.
abstract: 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).
authors.affiliation: Department of Psychiatry, Mount Sinai School of Medicine, New York, NY 10029.
authors.forename: J J
authors.initials: JJ
authors.lastname: Strain
authors.forename: L H
authors.initials: LH
authors.lastname: Gise
authors.forename: G
authors.initials: G
authors.lastname: Fulop
authors.forename: J J
authors.initials: JJ
authors.lastname: Strain
authors.forename: J S
authors.initials: JS
authors.lastname: Hammer
mesh_terms: 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*