The impact of psychiatric comorbidity on Medicare reimbursement for inpatient medical care.

Funding for psychiatric consultation-liaison (C-L) services has been a difficult problem. It has been suggested that the identification of psychiatric co-morbidities in Medicare patients on medical services could generate incremental hospital revenue by moving patients from a lower to a higher paying Diagnostic Related Group (DRG). This increased revenue could be used as a means of supporting the psychiatric C-L service.

Association of anticholinergic activity of prescribed medications with postoperative delirium.

In a prior study, delirium and plasma anticholinergic drug levels were significantly correlated in 9 of 25 surgical intensive care patients. The present study, using cumulative anticholinergic effects of parent compounds of these patients' medications, found that delirious patients' medication combinations had significantly higher cumulative anticholinergic effects than those of nondelirious patients.

Delirium in the surgical patient.

Delirium is a common and often unrecognized syndrome in hospitalized surgical patients. It can be caused by many different physical abnormalities, which are potentially correctable. Frequently, several etiologies coexist.