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Evaluation of Proactive C-L Psychiatry Program Demonstrates Heightened Value
‘Proactive C-L Psychiatry on hospital medicine units can add more value to health systems than traditional, on-demand psychiatry consults’
An economic evaluation of a one-year Proactive C-L Psychiatry program at a hospital medical unit has resulted in financial outcomes showing heightened value compared with traditional Psychiatry consultation on-demand services.
Few studies to date have provided such specific financial data that can be used to negotiate the setting up of proactive C-L Psychiatry programs.
Results of the research at Stony Brook University Hospital, New York—a suburban, academic 600+ bed tertiary care regional referral and safety-net hospital—are to be published in the Academy’s journal. The lead author is Brian Bronson, MD, who chairs the Academy’s C-L Psychiatry Division Directors’ forum.
Brian Bronson, MD
Dr. Bronson et al. evaluated the pilot’s return on investment and concluded: “Proactive C-L Psychiatry programs on hospital medicine units can add more value to health systems than traditional psychiatry consultation on-demand services by reducing the duration of hospitalization for persons with active psychiatric and substance use comorbid conditions, thereby allowing for additional bed-backfills and associated revenue which substantially offsets program costs.”
During the pilot the percent of discharges that received psychiatric consultation increased from 7.34% to 13.79%, and length of stay (LOS) for patients consulted on declined by a mean of 1.82 days, compared to an increase of 0.15 days on the traditional care units.
The one-year pilot LOS reduction saved 451.71 days in total, allowing for 73.81 bed-backfills, with a value of $419,343.
“Value in health care, often evaluated as the health outcomes per cost, should underlie all health care performance improvement activities,” say the authors. “The importance of demonstrating cost-effectiveness in C-L Psychiatry is increasingly appreciated; yet, despite growth in the field’s recognition, research regarding C-L Psychiatry’s value has resulted in inconsistent findings.”
By comparison, there is growing evidence that the Proactive C-L Psychiatry model provides value, mainly by reducing LOS. “The potential for enhanced value occurs by reducing the length of stay for patients receiving psychiatric consultation and producing a positive direct contribution margin by allowing for more backfills.”
The Academy of Consultation-Liaison Psychiatry is a professional organization of physicians who provide psychiatric care to people with coexisting psychiatric and medical illnesses, both in hospitals and in primary care. Our specialty is called consultation-liaison psychiatry because we consult with patients and liaise with their other clinicians about their care.
With nearly 2,000 members, the Academy is the voice of consultation-liaison psychiatry in the US with international reach.
Please browse our website, read our journal, Psychosomatics, and come to our annual meeting which is in November each year. In 2020 it will be a virtual event – see www.CLP2020.org for more details.
If you are a C-L Psychiatrist and not yet a member please join our great organization and welcoming, inclusive community. Please visit this page for details on joining.
