Inpatient pediatric psychology consultation-liaison program development: 5-year practice patterns and implications for trends in health care

The aim of the current study was to provide a detailed analysis of the practice patterns of an inpatient pediatric psychology consultation-liaison (CL) service over the first 5 years of development in order to further highlight the value of behavioral medicine in comprehensive, family-centered "medical home" models of care. A database was created detailing patient, referral concern and clinical intervention variables for all 1,749 consults completed during the 5-year period, and descriptive analyses were conducted. Referral concern and intervention data were examined separately for child versus caregiver targets, with referral concern data broken down further according to requesting medical team and intervention data broken down further according to referral concern. Financial data were also analyzed, particularly reimbursement rate and payment-per-full-time equivalent status. Consult demand and number of requesting medical teams increased over the 5-year period. Referral concerns differed across requesting medical teams. Primary interventions used reflected evidence-based care for both patients and caregivers. Payments per full-time equivalent also increased over the 5-year period. A CL service can provide components of evidence-based interventions to both patients and caregivers in the inpatient setting, and increasing capacity of behavioral health services can facilitate family-centered care approaches to comprehensive care provision, reflective of national trends in health care. Detailed analyses of practice patterns specific to medical teams and referral concerns can be used to strengthen business models supporting comprehensive care.