Department of Liaison Old Age Psychiatry, 63 Eccles Street, Dublin, 7, Ireland.
Ir J Med Sci. 2021 Nov;190(4):1529-1532. doi: 10.1007/s11845-020-02470-6. Epub 2021 Jan 15.
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.
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.
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.
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.
本研究采用自然主义研究方法，考察了精神科老年服务从咨询模式转变为联络模式的服务提供方式的改变所产生的影响。
研究期间分为两个阶段，由服务提供方式的改变界定。研究考察了这种变化对（1）转诊率、（2）转诊就诊率、（3）干预程度和（4）临床特征的影响。
尽管我们没有看到评估等待时间的显著改善（2.9 天 vs. 2.4 天），但增强后的团队提供了更多的临床投入。评估完成的数量增加了 60%（39 次 vs. 66 次）。最重要的是，在阶段 I 中，超过一半的转诊患者未得到就诊（54%），而在阶段 II 中，只有一名转诊患者未得到评估（1%）。审查的数量也显著增加。
本研究的结果表明，患者的治疗结果得到了改善，临床团队的满意度也有所提高。需要进一步开展临床有效性和成本效益研究。
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