title: Innovative reflecting interview: effect on high-utilizing patients with medically unexplained symptoms.
abstract: This pilot study was conducted to determine the effect of an innovative reflecting interview on the health care utilization, physical health, mental function, and health care satisfaction of high-utilizing primary care patients with medically unexplained physical symptoms. Twenty-four high-utilizing patients met study selection criteria and were randomly assigned to a no-intervention control group or a reflecting interview intervention group. Outcomes were measured at 4 weeks, 6 months, and 1 year after the date of study enrollment. Results indicated that high-utilizing patients with medically unexplained physical symptoms who participated in a reflecting interview had reduced total health care costs, primarily through the reduction of hospitalization or inpatient expenses, despite a modest increase in outpatient primary care clinic visits. These data suggest that participation in a reflecting interview and regular visits with a primary care clinician can decrease health care utilization without adversely affecting patient satisfaction.
authors.affiliation: Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota 55905, USA. rasmussen.norman@mayo.edu
authors.forename: Norman H
authors.initials: NH
authors.lastname: Rasmussen
authors.forename: Joseph W
authors.initials: JW
authors.lastname: Furst
authors.forename: Dana M
authors.initials: DM
authors.lastname: Swenson-Dravis
authors.forename: David C
authors.initials: DC
authors.lastname: Agerter
authors.forename: Alan J
authors.initials: AJ
authors.lastname: Smith
authors.forename: Macaran A
authors.initials: MA
authors.lastname: Baird
authors.forename: Stephen S
authors.initials: SS
authors.lastname: Cha
mesh_terms: D000328:Adult; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D010865:Pilot Projects; D011320:Primary Health Care / Q000191:economics* / Q000706:statistics & numerical data