[Consultation and liaison activity from the socioeconomic perspective. A plea for cost-benefit analysis in psychosomatics].
Within the last decade cost-effectiveness assumes a much more strategic perspective in the rationing of care that is taking place due to evidently increasingly limited financial resources and managed-care driven protocols. As universities and general hospitals face this increasing pressure to justify services within their facilities, consultation-liaison (C/L) programs need to carefully address and evaluate the financial base of the services they provide. Overlooking or neglecting the financial aspects of C/L-services has already resulted in the closure or service reduction of C/L-programs throughout the United States. Whereas a result of that development interest in cost-effectiveness research is considerable in the US and GB and has produced some good evidence for the impact of psychosocial problems on the outcome and cost of medical care, nearly no such studies come from the German-speaking countries. The present article reviews the worldwide existing literature concerning cost-effectiveness analyses of C/L-work and attempts to guide the reader through the currently available methods for cost-effectiveness research. As a conclusion we propose somatisation syndromes as one patient group. There the development of appropriate treatment regiments is vital both concerning clinical and socioeconomical aspects.
Gündel
H
H
Institut und Poliklinik für Psychosomatische Medizin, Psychotherapie und Medizinische Psychologie, TU München.
Siess
M
M
Ehlert
U
U
D003362:Cost-Benefit Analysis; D006801:Humans; D011611:Psychosomatic Medicine / Q000191:economics*; D012017:Referral and Consultation / Q000191:economics*