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Vol. 34. Issue 4.
Pages 195-201 (October - December 2020)
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Vol. 34. Issue 4.
Pages 195-201 (October - December 2020)
Original article
DOI: 10.1016/j.ejpsy.2020.06.001
Are there effects of consultation–liaison-psychiatry on length of stay in the general hospital? A path analysis
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M. Brunna,
Corresponding author
matthias.brunn@umontpellier.fr

Corresponding author.
, A. Diefenbacherb, J.J. Strainc
a CEPEL, CNRS, Université de Montpellier, Montpellier, France
b Department of Psychiatry and Psychotherapy, Charité – Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany
c Department of Psychiatry, Mount Sinai Hospital, New York City, United States
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Figures (1)
Tables (4)
Table 1. Demographic and procedural data (n=3190).
Table 2. Main psychiatric diagnosis (n=3190).
Table 3. Main somatic diagnosis (n=3190).
Table 4. Multiple regression of length of stay (N=3167).
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Abstract
Background and objectives

Recently, several publications have addressed interactions between selected factors related to the role of consultation–liaison (CL) psychiatric interventions and length of stay (LOS) in the general hospital anew. Yet at present, recent available research is restricted in the scope of factors studied. This study aims at providing an analysis of factors associated with LOS in a large sample of patients, with a broad set of variables and by accounting for the complex relationships between them.

Methods

Retrospective cohort analysis of n=3190 adult patients referred to the CL-psychiatry service of a general hospital. Univariate statistics and multiple regression were used to assess the association between patient characteristics and LOS. Path analysis was used to elucidate the mediating role of time-to-referral (TTR).

Results

Univariate analysis and multiple regression showed that TTR, age, and poor general functioning were associated with longer LOS. Diagnosis on Axis I+II (according to DSM), suicidal ideation and somatic diagnosis had no significant association with LOS. The four variables with the strongest total effect on LOS in the path analysis were TTR, the year of consultation, age and general functioning. Age had a higher indirect effect on LOS, while general functioning had a higher direct effect on LOS.

Conclusions

In the path model, TTR is a highly significant predictor of LOS and also a mediator of other predictors. This highlights the role of the CL-psychiatrist in the management of patients in the general hospital. Further research should investigate how referrals are prioritized by consultees and which different effects consultation recommendations might have on LOS.

Keywords:
Consultation-liaison psychiatry
Length of stay
Time-to-referral
Path analysis

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