|
| | |
|
Am J Psychiatry 1992; 149:631-637
Copyright © 1992 by American Psychiatric Association
A randomized controlled study of psychiatric consultation guided by screening in general medical inpatients
JL Levenson, RM Hamer and LF Rossiter
Department of Psychiatry, Medical College of Virginia, Virginia Commonwealth University, Richmond.
OBJECTIVE: The purpose of the study was to test the hypothesis that
psychiatric consultation would reduce health care utilization during and
after medical hospitalization. METHOD: A randomized, double- controlled
clinical trial of psychiatric consultation was conducted on the general
medical inpatient services of a university hospital. After meeting
inclusion criteria, 1,541 patients were screened for depression, anxiety,
confusion, and pain over a period of 21 months. The 741 patients with high
levels of psychopathology or pain were subdivided into baseline control
subjects (N = 232), contemporaneous control subjects (N = 253), and an
experimental consultation group (N = 256). The major outcome measures were
length of hospital stay and hospital costs. Secondary outcome measures were
posthospital health status, rehospitalization rates, and use of outpatient
medical care. RESULTS: This study did not demonstrate an effect of
experimental psychiatric consultation on hospital resource use or
posthospital medical care utilization after adjustment was made for disease
severity. Hospital resource use decreased in the entire sample over the
21-month duration of the study. CONCLUSIONS: The brief, efficient screen
for anxiety, depression, confusion, and pain identified a group of patients
who also used more hospital resources, but a single experimental
psychiatric consultation did not reduce costs. The double- controlled
nature of the design proved essential to avoid being misled by background
changes in hospital resource use.
This article has been cited by other articles:
|
|
|
|
 
V. de Albuquerque Citero, P. B. de Araujo Andreoli, L. A. Nogueira-Martins, and S. B. Andreoli
New Potential Clinical Indicators of Consultation-Liaison Psychiatry's Effectiveness in Brazilian General Hospitals
Psychosomatics,
February 1, 2008;
49(1):
29 - 38.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
Y. Kishi, W. H. Meller, R. G. Kathol, and S. E. Swigart
Factors Affecting the Relationship Between the Timing of Psychiatric Consultation and General Hospital Length of Stay
Psychosomatics,
December 1, 2004;
45(6):
470 - 476.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
P. B. d. A. Andreoli, V. d. A. Citero, and J. d. J. Mari
A Systematic Review of Studies of the Cost-Effectiveness of Mental Health Consultation-Liaison Interventions in General Hospitals
Psychosomatics,
December 1, 2003;
44(6):
499 - 507.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
P. de Jonge, C. H. M. Latour, and F. J. Huyse
Implementing Psychiatric Interventions on a Medical Ward: Effects on Patients' Quality of Life and Length of Hospital Stay
Psychosom Med,
November 1, 2003;
65(6):
997 - 1002.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
C. Boutin-Foster, S. J. Ferrando, and M. E. Charlson
The Cornell Psychiatric Screen: A Brief Psychiatric Scale for Hospitalized Medical Patients
Psychosomatics,
October 1, 2003;
44(5):
382 - 387.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
P. de Jonge, I. Bauer, F. J. Huyse, and C. H. M. Latour
Medical Inpatients at Risk of Extended Hospital Stay and Poor Discharge Health Status: Detection With COMPRI and INTERMED
Psychosom Med,
July 1, 2003;
65(4):
534 - 541.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
D. S. Kornfeld
Consultation-Liaison Psychiatry: Contributions to Medical Practice
Am J Psychiatry,
December 1, 2002;
159(12):
1964 - 1972.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
H. G. Rincon, M. Granados, J. Unutzer, M. Gomez, R. Duran, M. Badiel, C. Salas, J. Martinez, J. Mejia, C. Ordonez, et al.
Prevalence, Detection and Treatment of Anxiety, Depression, and Delirium in the Adult Critical Care Unit
Psychosomatics,
October 1, 2001;
42(5):
391 - 396.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
R. Sturm
Economic Grand Rounds: The Myth of Medical Cost Offset
Psychiatr Serv,
June 1, 2001;
52(6):
738 - 740.
[Full Text]
[PDF]
|
|
|
|
|
|
|
K. Franco, D. Litaker, J. Locala, and D. Bronson
The Cost of Delirium in the Surgical Patient
Psychosomatics,
February 1, 2001;
42(1):
68 - 73.
[Abstract]
[Full Text]
|
|
|
|
|
|
|
P. de Jonge, F. J. Huyse, G. M.-F. Ruinemans, F. C. Stiefel, J. S. Lyons, and J. P.J. Slaets
Timing of Psychiatric Consultations: The Impact of Social Vulnerability and Level of Psychiatric Dysfunction
Psychosomatics,
December 1, 2000;
41(6):
505 - 511.
[Abstract]
[Full Text]
|
|
|
|
|
|
|
B. M. Booth, F. C. Blow, and C. A. Loveland Cook
Functional Impairment and Co-occurring Psychiatric Disorders in Medically Hospitalized Men
Arch Intern Med,
July 27, 1998;
158(14):
1551 - 1559.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
D. B. Reuben, G. M. Borok, G. Wolde-Tsadik, D. H. Ershoff, L. K. Fishman, V. L. Ambrosini, Y. Liu, L. Z. Rubenstein, and J. C. Beck
A Randomized Trial of Comprehensive Geriatric Assessment in the Care of Hospitalized Patients
N. Engl. J. Med.,
May 18, 1995;
332(20):
1345 - 1350.
[Abstract]
[Full Text]
[PDF]
|
|
|
Get information about faster international access.
Privacy Policy
Copyright © 1992
American Psychiatric Association.
All rights reserved.
Home
| Search
| Current Issue
| Past Issues
| Subscribe
| All APPI Journals
| Help
| Contact Us
|
