Are there effects of consultation-liaison-psychiatry on length of stay in the general hospital? A path analysis

Background and objectives: Recently, several publications have addressed interactions between selected factors related to the role of consultation-liaison (CL) psychiatric inter ventions and length of stay (LOS) in the general hospital anew. Yet at present, recent available research is restricted in the scope of factors studied. This study aims at providing an analysis of factors associated with LOS in a large sample of patients, with a broad set of variables and by accounting for the complex relationships between them. Methods: Retrospective cohort analysis of n =3190 adult patients referred to the CL-psychiatry service of a general hospital. Univariate statistics and multiple regression were used to assess the association between patient characteristics and LOS. Path analysis was used to elucidate the mediating role of time-to-referral (TTR). Results: Univariate analysis and multiple regression showed that TTR, age, and poor general functioning were associated with longer LOS. Diagnosis on Axis I + II (according to DSM), suicidal ideation and somatic diagnosis had no significant association with LOS. The four variables with the strongest total effect on LOS in the path analysis were TTR, the year of consultation, age and general functioning. Age had a higher indirect effect on LOS, while general functioning had a higher direct effect on LOS. Conclusions: In the path model, TTR is a highly significant predictor of LOS and also a mediator of other predictors. This highlights the role of the CL-psychiatrist in the management of patients in the general hospital. Further research should investigate how referrals are prioritized by consultees and which different effects consultation recommendations might have on LOS. (C) 2020 Asociacion Universitaria de Zaragoza para el Progreso de la Psiquiatria y la Salud Mental. Published by Elsevier Espana, S.L.U. All rights reserved.