Mitchell W D, Thompson T L
Gen Hosp Psychiatry. 1985 Oct;7(4):349-52. doi: 10.1016/0163-8343(85)90050-7.
Psychiatry needs to conduct more rigorously designed empirical research studies to demonstrate its cost-effectiveness, especially since the DRG era is becoming more firmly established. The effectiveness of psychiatric intervention can be evaluated on its abilities to improve physical functioning as well as its improvement of psychosocial symptoms and cost savings. Some of the problems in consultation-liaison research are discussed, including the potentially confounding influences of demographic variables, type and severity of somatic disease, time since diagnosis, level of psychosocial stress, and initial level of physical functioning. Several types of research measures used in assessing physical and psychosocial functioning are discussed, and some of the dilemmas for psychiatry in utilizing individual versus standardized research interventions are explored.
精神病学需要开展设计更为严谨的实证研究，以证明其成本效益，尤其是在诊断相关分组（DRG）时代日益稳固的情况下。精神科干预的有效性可以通过其改善身体机能的能力、改善心理社会症状的能力以及节省成本的能力来评估。文中讨论了会诊联络研究中的一些问题，包括人口统计学变量、躯体疾病的类型和严重程度、确诊后的时间、心理社会压力水平以及身体机能的初始水平等可能产生的混杂影响。文中还讨论了评估身体和心理社会机能时使用的几种研究方法，并探讨了精神病学在采用个体研究干预措施与标准化研究干预措施时面临的一些困境。
