Psychiatric consultation service in elderly patients - changes due to new German laws concerning guardianship and reforms in the structure of health care providers

In the discussion of increasing costs of health care in Germany, the freque nt and long hospital stays of elderly patients are often pointed out. Since these patients very frequently suffer from psychiatric disorders, psychiat ric consultation is often required. This study was aimed at investigating w hether new German laws concerning guardianship and the structure of health care providers change conditions for psychiatric consultation services. For this purpose, the documentation of all consultations in the years 1991 to 1995 was retrospectively evaluated. In about 3% of all patients aged over 6 5 referred to the General University Hospital of Lubeck, psychiatric consul tation was ordered. The most frequent diagnosis was senile dementia. Compar ison of the requests and psychiatric recommendations show a significant inc rease in wishes and recommendations for guardianship. Moreover, there is ev idence of the increasing need of consultation in elderly patients. Possibly due to the new law concerning the structure of health care providers and t he number of requests and recommendations to transfer patients to psychiatr ic wards, these results show that the new laws do affect psychiatric consul tation.