More timely psychiatric consultations could improve patient outcomes and cut costs by reducing hospital stays, reported Yasuhiro Kishi, M.D., and associates at the University of Minnesota, Minneapolis.
They reviewed the medical records of 541 consecutive patients referred for psychiatric consultation at the Fairview-University Medical Center at the university between Jan. 1, 2001, and Dec. 31, 2001 (Psychosomatics 2004;45:470–6).
The mean length of a hospital stay during the study period was 5.7 days for all patients and 18 days for patients who received psychiatric consultation. Referral time was the most predictive factor; a longer time to referral was significantly associated with a longer length of stay.
The two recommendations from a psychiatric consultation that predicted shorter stays were transfer to inpatient psychiatry and follow-up in outpatient psychiatry.
A pharmacotherapy recommendation was significantly associated with a longer stay. Although 191 patients (35%) were referred for depression, 23% of these patients were not diagnosed with depression by a psychiatrist during their referral consultations.
Overall, patients with blatant psychiatric problems were not at risk of delayed treatment, but women and patients with nonpsychiatric disorders who were in greater need of psychosocial intervention rather than psychiatric interventions were at risk for postponed care, the researchers noted.