Excess health care service utilization and costs associated with underrecognition of psychiatric comorbidity in a medical/surgical inpatient setting

Psychiatric comorbidity is common among chronically medically ill populations and the presence of psychiatric conditions tends to be associated with increased costs and excess utilization of general medical services. The purpose of this pilot investigation was to determine whether differences in non...

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Bibliographic Details
Published in:	Quality management in health care Vol. 20; no. 2; pp. 98 - 102
Main Authors:	Borckardt, Jeffrey J, Madan, Alok, Barth, Kelly, Galloway, Sarah, Balliet, Wendy, Cawley, Patrick J, Pelic, Christine, Hargett, Steve, Rublee, Steve, McLeod-Bryant, Stephen, Malcolm, Robert, Uhde, Thomas
Format:	Journal Article
Language:	English
Published:	United States Lippincott Williams & Wilkins Ovid Technologies 01-04-2011
Subjects:	Comorbidity Costs Health administration Health care expenditures Health Expenditures - statistics & numerical data Health Services - economics Health Services - utilization Hospitalization Hospitalization - economics Hospitalization - statistics & numerical data Humans Inpatient care Length of stay Length of Stay - statistics & numerical data Mental Disorders - complications Pilot Projects Psychiatry Studies
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Summary:	Psychiatric comorbidity is common among chronically medically ill populations and the presence of psychiatric conditions tends to be associated with increased costs and excess utilization of general medical services. The purpose of this pilot investigation was to determine whether differences in nonpsychiatric inpatient hospitalization frequency, duration, and costs existed between patients receiving outpatient psychiatric treatment and patients without identified psychiatric problems. Length of stay and cost information for patients that had at least 1 inpatient medical/surgical hospitalization during a 6-month period was extracted from the hospital's inpatient billing database (n = 10,865). The medical record numbers of these patients were then cross-referenced against the outpatient psychiatry-billing database for the same 6-month period, thereby identifying all patients that had both a nonpsychiatric inpatient hospitalization and an outpatient psychiatry visit (n = 149). Patients identified as having outpatient psychiatry involvement had significantly more nonpsychiatric hospitalizations on average (mean = 1.60) than nonpsychiatric patients (mean = 1.34) during the study period (t4381 = 2.94, P = .003). There was no difference in the total costs associated with these hospitalizations between the 2 groups. Those that had a psychiatry consult during the nonpsychiatric hospitalization had a significantly higher length of stay and costs than those without. Thus, the criteria used to determine whether or not a psychiatry consultation is triggered, and the timing of the consultation request need further study.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1063-8628 1550-5154
DOI:	10.1097/QMH.0b013e3182134af0