Consultation-Liaison Psychiatry Interventions: The Sooner, The Better.

Abstract

Objective: Psychiatric disorders are common among general hospital patients. A large study conducted previously showed that timely contact with a consultation-liaison psychiatry (CLP) service is associated with a shorter length of stay (LOS). The aim of this work was to replicate this study with recent data covering the pandemic period to confirm the impact of timely contact with CLP on LOS.

Methods: We retrospectively included 2070 patients referred to CLP between 2018 and 2022 at the University Hospital of Lille. General linear models were used to assess associations between the timing of CLP interventions and LOS and to identify predictors of the timing of CLP interventions (eg, age, sex, type of ward, psychiatric diagnosis, and year of admission).

Results: The timing of CLP interventions was significantly positively associated with LOS. Referral time (ie, log(days before consultation)/log(LOS)) was significantly associated with log-transformed LOS (model 1: β=0.11, p <.001), and this association remained consistent after adjustment for covariates (model 2: β=0.13, p <.001). Admissions in 2020 and 2021 were associated with shorter times before CLP interventions (Model 3: β =-0.06, p =.020 and β =-0.06, p =.022, respectively), whereas surgical and intensive care admissions were associated with longer times to consultation (model 3: β =0.04, p =.036 and β =0.08, p <.001, respectively).

Conclusions: The present study confirms that earlier CLP intervention is associated with shorter LOS in general hospitals. The COVID health emergency provided an opportunity to demonstrate the benefits of early psychiatric consultation to reduce LOS.