Psychiatrists waste 1 million hours getting patients admitted

U.S. psychiatrists spend an average 38 minutes telephoning an insurance company getting authorization to admit a patient to the hospital, researchers say.

Lead author Dr. Amy Funkenstein, a child psychiatry fellow at Brown University in Providence, R.I., led the study while she was a psychiatric resident at Cambridge Health Alliance and Harvard Medical School in Boston.

Over a three-month period, the researchers tabulated how long psychiatric patients who were deemed in need of inpatient admission stayed in the emergency department prior to being hospitalized, and the amount of time the ED psychiatrists spent obtaining authorization from the patient's insurer.

Most psychiatric patients required hospitalization because they were suicidal or, in a few cases, homicidal, Funkenstein said.

A group of 11 psychiatric residents at Cambridge Health Alliance working in the psychiatric ED with acutely ill psychiatric patients collected the data.

The study, published in the Annals of Emergency Medicine, found the median total time in the ED was 8.5 hours, with the shortest stay lasting 3 hours and the longest 20 hours.

With approximately 1.6 million psychiatric admissions among people with private insurance nationwide each year, 38 minutes of phone time to obtain authorization translates into about 1 million hours of wasted psychiatrist time, Funkenstein said.

"Society pays for inadequate psychiatric care; more than half of all prison inmates and a third of all homeless people are mentally ill," Funkenstein said in a statement.