Evaluation of the value of team-based psychiatric consultation in a general hospital setting

Catherine Orsak, Abey Thomas, Paul Bush, E. Sherwood Brown

Research output: Contribution to journalArticle

Abstract

Background: With the increase use of pay for performance in healthcare, 30-day readmissions after discharges are critically important. Objective: A team-based psychiatric consultation approach was tested in an inpatient hospital setting. This is the first study that examines 30-day readmission rate with this approach. Methods: In this quality improvement study, 164 patients received a team-based psychiatric consultation that included daily meetings during the weekdays between psychiatrists and hospitalists and 436 received care of treatment-as-usual or traditional consultation–liaison services. Results: Overall 30-day readmission rate was not significantly different between intervention and nonintervention groups. However, in subgroups with high risk of mortality or severe illness, the intervention group had a 0% 30-day readmission rate for both high risk of mortality and severe illness subgroups, while the nonintervention group’s readmission rate was 5% for high risk of mortality group and 3% for severely ill patients. Annual hospital cost saving is estimated between a quarter million and 1.5 million dollars for these subgroups. Conclusion: The team-based psychiatric consultation approach demonstrated the potential for substantial cost savings in providing care for patients with high risk of mortality and severe illness. Thus, this intervention may be very useful in caring for patients with complex chronic conditions.

Original languageEnglish (US)
Pages (from-to)282-291
Number of pages10
JournalInternational Journal of Psychiatry in Medicine
Volume53
Issue number4
DOIs
StatePublished - Jul 1 2018

Keywords

  • medical illness
  • psychiatry
  • psychopharmacology

ASJC Scopus subject areas

  • Psychiatry and Mental health

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