Health care utilization of somatizing patients in a pulmonary subspecialty clinic.
Somatizing patients present with medically unexplained physical complaints, repeat clinic visits, and a history of prior extensive testing. The authors reviewed 1,908 pulmonary consultation reports for 1990-1991 for evidence of somatization, yielding a group of 41 (2%) patients for study. Billing records were obtained and were compared to asthmatic patients and those in a health maintenance organization (HMO). Health care costs for the somatizing patients were significantly higher than the average cost for HMO patients and comparable to the health costs for patients with asthma. Half of the somatizing patients had psychological problems indicated in their medical records, but few received psychiatric referral or treatment. Management of the somatizing patient within the specialty clinic and on-site psychiatric treatment are suggested as ways to decrease unnecessary health care utilization.
Labott
S M
SM
Departments of Psychiatry and Pulmonary and Critical Care Medicine, Henry Ford Hospital, Detroit, MI.
Preisman
R C
RC
Popovich
J
J
Iannuzzi
M C
MC
D000293:Adolescent; D000328:Adult; D000368:Aged; D001249:Asthma / Q000191:economics / Q000453:epidemiology* / Q000523:psychology; D002648:Child; D002675:Child, Preschool; D003362:Cost-Benefit Analysis; D005260:Female; D006279:Health Maintenance Organizations / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D008173:Lung Diseases, Obstructive / Q000191:economics / Q000453:epidemiology* / Q000523:psychology; D008297:Male; D008875:Middle Aged; D012017:Referral and Consultation / Q000191:economics / Q000706:statistics & numerical data*; D013001:Somatoform Disorders / Q000191:economics / Q000453:epidemiology* / Q000523:psychology; D014481:United States; D014600:Utilization Review