Old age psychiatry in the house: assessing the impact of a service transition from consultation to liaison old age psychiatry.

OBJECTIVE

The impact of a change in service delivery in a psychogeriatric service, moving from a consultation model to liaison model of care, was examined in a naturalistic study.

METHODS

The study period was divided into two phases, defined by the change in service delivery. The impact of the change on (1) referral rate, (2) referrals seen, (3) extent of intervention and (4) clinical characteristics was examined.

RESULTS

While we did not see a dramatic improvement in time waiting for assessment (2.9 vs. 2.4 days), the enhanced team provided significantly more clinical input. The number of assessments completed increased by 60% (39 vs. 66). Most significantly, during phase I, more than half of all referrals were not seen (54%), while during phase II only one patient referred was not assessed (1%). The number of reviews undertaken also increased significantly.

CONCLUSIONS

The results of the present study suggest improved outcomes for patients and improved satisfaction in the clinical teams. Further clinical effectiveness and cost-effectiveness studies are needed.