Effect of changing referral mode to C-L Psychiatry for noncognitively impaired medical inpatients with emotional disorders.
OBJECTIVE
To test the effect of changing referral mode to Consultation-Liaison Psychiatry (C-L Psychiatry) by implementing early screening with systematic multidisciplinary management for emotional disorders in noncognitively impaired medical inpatients.


METHODS
A prospective pre- and postintervention controlled study in the internal medicine division of a university hospital.


RESULTS
Out of 515 patients admitted to the internal medicine ward during the study period, 176 were included in the study and gave their informed consent (male=63%); 81 in the control group and 95 in the intervention group. Except for the increase in referral rate to the C-L Psychiatry service (4-32%), there were no significant differences between the baseline and intervention periods either in terms of length of stay in the internal medicine ward and of use and costs of medical resources, or in terms of patients' satisfaction as regards attention paid to psychosocial issues during hospitalization.


CONCLUSIONS
As a result of changing referral mode to C-L Psychiatry, the lack of effect on length of stay and on medical consumption of medically ill inpatients should be considered in the context of the briefness of the hospitalization periods encountered. Furthermore, the change in referral process does not seem to increase patients' perception of the quality of care provided.
Camus
Vincent
V
Geriatric Psychiatry Consultation-Liaison Unit, CHUV 1011, Lausanne, Switzerland. vincent.camus@inst.hospvd.ch
Viret
Claude
C
Porchet
Alain
A
Ricciardi
Paola
P
Bouzourène
Karim
K
Burnand
Bernard
B
D000328:Adult; D000342:Affective Symptoms / Q000175:diagnosis* / Q000191:economics / Q000628:therapy*; D000368:Aged; D015897:Comorbidity; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data; D006760:Hospitalization / Q000706:statistics & numerical data*; D006785:Hospitals, University; D006801:Humans; D007297:Inpatients; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011570:Psychiatry / Q000592:standards; D011787:Quality of Health Care; D012017:Referral and Consultation