title: Frequent attenders with medically unexplained symptoms: service use and costs in secondary care.
abstract: BACKGROUND
  Frequent attenders in medical settings account for a disproportionate amount of health-care resources. Little is known about service use and costs of secondary care in those frequent attenders presenting with medically unexplained symptoms.
  
  
  OBJECTIVE
  To compare health-care use and costs of patients with medically unexplained symptoms with other frequent attenders in secondary care.
  
  
  METHODS
  In a sample of 400 frequent attenders of secondary care services, those presenting with medically unexplained symptoms were identified by a review of medical records. Their use of health-care resources was compared with that of other frequent attenders.
  
  
  RESULTS
  Of the frequent attenders 17% had at least two medically unexplained consultation episodes. These patients had a greater number of referrals to secondary care and were more likely to undergo particular investigations.
  
  
  CONCLUSIONS
  Frequent attenders with medically unexplained symptoms account for levels of service use and expenditure that are comparable with other frequent attenders, but the use and cost of medical investigations in this group are significantly greater.
authors.affiliation: Academic Department of Psychological Medicine, Guy's, King's and St Thomas' School of Medicine and Institute of Psychiatry, London.
authors.forename: Steven
authors.initials: S
authors.lastname: Reid
authors.forename: Simon
authors.initials: S
authors.lastname: Wessely
authors.forename: Tim
authors.initials: T
authors.lastname: Crayford
authors.forename: Matthew
authors.initials: M
authors.lastname: Hotopf
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000553:Ambulatory Care / Q000191:economics / Q000706:statistics & numerical data*; D015331:Cohort Studies; D004739:England; D005260:Female; D017721:Hospital Costs; D006801:Humans; D008297:Male; D008875:Middle Aged; D010044:Outpatient Clinics, Hospital / Q000191:economics / Q000706:statistics & numerical data*; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D013001:Somatoform Disorders / Q000628:therapy*; D013222:State Medicine / Q000191:economics / Q000706:statistics & numerical data