Recent changes in consultation-liaison psychiatry. A blueprint for the future.
To better understand the changes in the past 5 years on consultation-liaison (C-L) services in the United States, 119 university programs were surveyed. The return response was 64%. Of the 76 respondents, 32% had decreased funding, 54% no changes or stable finding, and 14% improved funding. Nonetheless, 57% of the programs reported funding difficulties as a major problem. Understaffing was reported by 51% of the programs. Liaison activities have ceased or are reduced in 70% of the programs; 15% reported an increase in liaison, particularly for transplantation. C-L services have been affected by illness acuity (68%), shorter hospital stays (79%), and older populations (54%). The diagnostic mix shows increases in HIV-related disorders, drug abuse, and delirium. The discussion includes recommendations for C-L services given these findings.
Cavanaugh
S
S
Department of Psychiatry, Rush-Presbyterian-St. Luke's Medical Center, Chicago, IL 60612.
Milne
J
J
D003131:Combined Modality Therapy; D005257:Fellowships and Scholarships / Q000639:trends*; D005544:Forecasting; D006801:Humans; D010348:Patient Care Team / Q000639:trends*; D011570:Psychiatry / Q000193:education*; D011611:Psychosomatic Medicine / Q000193:education*; D011785:Quality Assurance, Health Care / Q000639:trends; D012017:Referral and Consultation / Q000639:trends; D016896:Treatment Outcome; D014481:United States