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Irish Journal of Medical Science

, Volume 180, Issue 2, pp 395–399 | Cite as

Liaison neurologists facilitate accurate neurological diagnosis and management, resulting in substantial savings in the cost of inpatient care

  • L. Costelloe
  • D. O’Rourke
  • T. S. Monaghan
  • A. J. McCarthy
  • R. McCormack
  • J. A. Kinsella
  • A. Smith
  • R. P. Murphy
  • D. J. H. McCabe
Original Article

Abstract

Background

Despite understaffing of neurology services in Ireland, the demand for liaison neurologist input into the care of hospital inpatients is increasing. This aspect of the workload of the neurologist is often under recognised.

Aims/methods

We prospectively recorded data on referral and service delivery patterns to a liaison neurology service, the neurological conditions encountered, and the impact of neurology input on patient care.

Results

Over a 13-month period, 669 consults were audited. Of these, 79% of patients were seen within 48 h and 86% of patients were assessed by a consultant neurologist before discharge. Management was changed in 69% cases, and discharge from hospital expedited in 50%. If adequate resources for neurological assessment had been available, 28% could have been seen as outpatients, with projected savings of 857 bed days.

Conclusions

Investment in neurology services would facilitate early accurate diagnosis, efficient patient and bed management, with substantial savings.

Keywords

Liaison neurologist Consultant-delivered consult service Prospective audit Diagnosis and management Inter-observer agreement Bed days saved 

Notes

Acknowledgments

Dr. Justin Kinsella’s research was funded by grants from the Stanley Thomas Johnson Foundation, and by unrestricted educational grant funding from Bayer Schering Ireland, Pfizer Ireland and Elitech UK.

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Copyright information

© Royal Academy of Medicine in Ireland 2010

Authors and Affiliations

  • L. Costelloe
    • 1
  • D. O’Rourke
    • 1
  • T. S. Monaghan
    • 1
  • A. J. McCarthy
    • 1
  • R. McCormack
    • 1
  • J. A. Kinsella
    • 1
  • A. Smith
    • 2
  • R. P. Murphy
    • 1
  • D. J. H. McCabe
    • 1
    • 3
  1. 1.Department of NeurologyThe Adelaide and Meath Hospital, Dublin, Incorporating the National Children’s Hospital, Trinity College DublinDublin 24Ireland
  2. 2.National Cancer Screening ServiceDublinIreland
  3. 3.Department of Clinical Neurosciences, Royal Free CampusUCL Institute of NeurologyLondonUK

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