Differences in care intensity held by a consultation-liaison service in a general hospital among patients suffering from different somatic illnesses

Abstract

Background

There are differences in psychiatric comorbidity and perceived diagnosing and psychological supporting needs depending on professionals, units, programs, awareness, and diagnoses.

Objectives

This investigation explores possible differences in psychiatric comorbidity, in care intensity and in care priorities by a psychiatric-psychosomatic consultation-liaison service among main physical disease groups.

Methods

Three-year survey (n = 1,862 individuals) about all elective referrals from 16 different units in a middle-sized general hospital with 520 beds and 34,000 treated patients per annum. Five clinical and six care variables have been selected from the collected data by means of basic documentation of CLS. Chi-square-tests and ANOVA including Scheffé post-hoc test as well as multivariate regression analyses with robust regression coefficients were performed.

Results

The sample consisting of 55% women is on average 61 years old, 79% showing current and 35% psychiatric comorbidity prior to hospitalisations. Average GAF amounted to 67.2 (SD = 20.5) and ECOG to 1.22 (SD = 1.38). Psychosomatic disorders (F4) amounted to 38%, mood disorders (F3) to 19% and mental organic disorders (F0) to 11% of psychiatric disorders. Each patient received on average 2.11 (SD = 2.63) contacts and 105 minutes (SD = 144) of treatment time, 59% psychopharmacological and 32% psychotherapeutic interventions. Men and older people receive less, but comorbid patients independently of age and gender more intensive psychological support. There are hardly differences according to physical diseases.

Discussion

Cancer patients show less psychiatric comorbidity, but more psychotherapeutic interventions. Patients suffering from psychiatric comorbidity received more intensive care and more post-discharge recommendations. Patients treated because of chronic pain received much more interventions and treatment time.

Disclosure of interest

The authors have not supplied their declaration of competing interest.