[Effects of psychotherapeutic interventions on length of stay in cardiology inpatients].
OBJECTIVE
Mental comorbidities as recorded in the DRG system by the Patient Comorbidity and Complication Level (PCCL) cause extended length of stay in cardiology with resultant higher costs. Studies analyzing the influence of a psychiatric consultation and liaison service on the length of stay and the costs incurred thereby have generated inconsistent results. The present prospective study examines the effects of the psychotherapeutic liaison service on the length of stay.


METHODS
In the course of 6 months, two cardiology wards were alternately provided traditional psychotherapeutic consultation and psychotherapeutic liaison service based on a Cross-Over-Design (A-B-A). Inclusion criteria for patients was the presence of one of the four most common cardiological diagnoses (ischemic heart diseases, heart valve defects, cardiomyopathies, arrhythmias). After the exclusion of patients with a length of less than five days, the random sampling comprised n = 317 patients.


RESULTS
The study showed no direct correlation between the intensified care system of the liaison service and a reduction in the length of stay. The results obtained remained consistent even after controlling for age, sex, and case complexity. Recommendations for further investigations are discussed.
Fritzsche
Kurt
K
Abteilung für Psychosomatische Medizin und Psychotherapie am Universitätsklinikum Freiburg, Hauptstrasse 8, D-79104 Freiburg. kurt.fritzsche@uniklinik.freiburg.de
Braun
Philipp
P
Schweickhardt
Axel
A
Geibel
Annette
A
D000223:Adaptation, Psychological; D000368:Aged; D016507:Cardiology Service, Hospital / Q000706:statistics & numerical data*; D015928:Cognitive Behavioral Therapy; D015897:Comorbidity; D018592:Cross-Over Studies; D005260:Female; D005858:Germany; D006331:Heart Diseases / Q000453:epidemiology / Q000523:psychology* / Q000628:therapy; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010348:Patient Care Team; D011613:Psychotherapy; D012017:Referral and Consultation; D012803:Sick Role; D013001:Somatoform Disorders / Q000453:epidemiology / Q000523:psychology* / Q000628:therapy