Clinical and care intensity differences among patients suffering from somatic diseases electively referred to a consultation and liaison service

Abstract

Background

This investigation mainly explores possible care differences among patients hospitalized because of medical conditions being electively referred to a psychiatric-psychosomatic consultation and liaison service.

Methods

A four-year survey (N = 2518 individuals) based on clinical and care variables selected from the basic documentation. Statistics: Chi-square tests, analysis of variance, logistic and multivariate regression analyses, considering statistical modeling assumptions.

Results

A current psychiatric comorbidity has been found in 75% (less in cancer patients), mainly adjustment and anxiety (45%), mood (22%), and organic mental disorders (12%). The functioning score (Global Assessment of Functioning) was 59.4 and was especially low in patients suffering from unclear medical conditions. The performance status (Eastern Cooperative Oncology Group) amounted to 1.63 and was especially high in patients suffering from orthopedic conditions, infections, and cancer. Each patient received on average of 2.26 (SD = 2.81) contacts and 111 minutes (SD = 160) of total treatment time. In multivariate models, care differences among medical conditions are reduced. Men and older people have received less than the average amount of treatment, but psychiatrically comorbid patients and those with lower functionality and performance status have received more intensive psychological support.

Conclusions

As a quality feature of consultation and liaison service, patients suffering from psychiatric comorbidity, lower functionality, and lower performance status receive more intensive care and more post-discharge recommendations. Cancer patients and patients with pain as a leading diagnosis as well as strained mothers of hospitalized children have received more intensive treatment by consultation and liaison service despite lower psychiatric comorbidity levels. More attention has to be paid to men and older people independently of their physical condition.

Keywords

consultation and liaison psychiatry mental illness medical illness comorbidity

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