Consultation--liaison psychiatry. Possibilities for the 1990s.
In order for consultation-liaison (C/L) psychiatry to enhance its acceptance and funding, carefully designed outcome studies that will demonstrate its clinical effectiveness to other disciplines in medicine, departments of psychiatry, hospital administration, third-party payors, and patients are required. The development of alternative methods of funding C/L services is described: (1) high-risk screening, renal transplant, geriatric units (Medicare); (2) salary stipends from collaborating disciplines, e.g., medicine, ENT, neoplastics; (3) consultation fees; (4) ambulatory C/L clinics (Medicaid); and (5) grants from collaborative research. With a change in structure when it can be employed (from consultation to the screen methodology), the development of scientifically derived outcome data of C/L psychiatry interventions, adequate documentation of the evaluation and treatment by C/L psychiatry, and the new tools biological psychiatry and psychopharmacology will provide, the 1990s could and should be an exciting time for this subspecialty of psychiatry.
Strain
J J
JJ
Division of Behavioral Medicine and Consultation Psychiatry, Mount Sinai Hospital, New York, New York 10029.
Gise
L H
LH
Fulop
G
G
D005544:Forecasting; D006769:Hospitals, General / Q000458:organization & administration; D006801:Humans; D010043:Outcome and Process Assessment, Health Care / Q000191:economics / Q000639:trends; D011570:Psychiatry / Q000191:economics* / Q000639:trends; D012017:Referral and Consultation / Q000191:economics* / Q000639:trends; D012106:Research