Abstract
IntroductionPsychiatric illness impacts nearly one-quarter of the US population. Few studies have evaluated the impact of psychiatric illness on in-hospital trauma patient care. In this study, we conducted a retrospective cohort study to evaluate hospital resource utilization for trauma patients with comorbid psychiatric illnesses.MethodologyTrauma patients admitted to a level I center over a one-year period were included in the study. Patients were categorized into one of three groups: (1) no psychiatric history or in-hospital psychiatric service consultation; (2) psychiatric history but no psychiatric service consultation; and (3) psychiatric service consultation. Time to psychiatric service consultation was calculated and considered early if occurring on the day of or the day following admission. Patient demographics, outcomes, and resource utilization were compared between the three groups.ResultsA total of 1,807 patients were included in the study (n = 1,204, 66.6% no psychiatric condition; n = 508, 28.1% psychiatric condition without in-hospital psychiatric service consultation; and n = 95, 5.3% in-hospital psychiatric service consultation). Patients requiring psychiatric service consultation were the youngest (P < .001), with the highest injury severity (P = .024), the longest hospital length of stay (P < .001), and the highest median hospital cost (P < .001). Early psychiatric service consultation was associated with an average saving in-hospital length of stay of 2.9 days (P = .021) and an average hospital cost saving of $7,525 (P = .046).ConclusionOne-third of our trauma population had an existing psychiatric diagnosis or required psychiatric service consultation. Resource utilization was higher for patients requiring consultation. Early consultation was associated with a savings of hospital length of stay and cost.
Highlights
Psychiatric illness impacts nearly one-quarter of the US population
Lyons et al concluded no significant difference in hospital cost, Zatzick et al.'s study suggested psychiatric diagnoses were associated with increased hospital length of stay and cost, and these authors concluded future research should investigate the impact of the early psychiatric diagnosis on outcomes
A study conducted in the year 2000 found 29% of trauma patients had a psychiatric illness and called for future research to investigate the impact of early diagnosis on outcomes as a way to more efficiently provide treatment to this group
Summary
The purpose of this study was to provide a contemporary evaluation of hospital resource utilization for trauma patients with psychiatric illness versus those without and to explore the impact of timing of psychiatric consultation on hospital-related outcomes and costs. The purpose of this paper was to evaluate hospital resource utilization for trauma patients with psychiatric illnesses
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