자문조정부서 발족전후 자문의들의 권고에 대한 자문의뢰의들의 일치도의 비교

A Compatison of Consultees’ Concordance with Consultants’ Recommendations Before and After Organization of the Consultation-liaison Service

The study was perform ed to evaluate the effectiveness of psychiatric consultation after organization o f the consultation-liaison service. A com parison was m ade regarding consultees’ concordance with consultants, recom m endations over each period o f one year in 1981 and 1986. T he findings are as follow i 1) Psychotropic m edication showed the highest concordance o f all the recom m endations in each period of 1981 and 1986. However, the concordance rate for psychotropic usage tended to be decreased after organization o f the service. 2) The concordance rate for transfer was significantly decreased in spite o f increase of consultants，recom m endations for transfer after organization o f the service. 3) There was no significant difference in the concordance rate for each of psychiatric diagnosis and psychological test during the interim period. 4) The concordance rate for diagnosis was significantly increased after organization of the service, w hen no psychiatric diagnosis was considered by consultees prior to psychiatric consultation. 5) The concordance rate for transfer was the highest in organic m ental disorder and som atoform disorder, whereas it was the lowest in psychosom atic disorder after organization o f the service. 6) The concordance rate for transfer in internal m edicine was the lowest, in spite of the highest rate of recom m endations for transfer in the departm ent am ong the referring departm ents after organization of the service. In conclusion, it was found that transfer was more potent source of conflict between consultants and consultees after organization o f the consultation-liaison service. It is suggested that transfer should be cautiously recom m ended for these consultation patients, especially the so-called psychosom atic ones.