title: Patients with unexplained physical symptoms have poorer quality of life and higher costs than other patient groups: a cross-sectional study on burden.
abstract: BACKGROUND
  To determine whether healthcare resources are allocated fairly, it is helpful to have information on the quality of life (QoL) of patients with Unexplained Physical Symptoms (UPS) and on the costs associated with them, and on how these relate to corresponding data in other patient groups. As studies to date have been limited to specific patient populations with UPS, the objective of this study was to assess QoL and costs in a general sample of patients with UPS using generic measures.
  
  
  METHODS
  In a cross-sectional study, 162 patients with UPS reported on their QoL, use of healthcare resources and lost productivity in paid and unpaid work. To assess QoL, the generic SF-36 questionnaire was used, from which multidimensional quality-of-life scores and a one-dimensional score (utility) using the SF-6D scorings algorithm were derived. To assess costs, the TiC-P questionnaire was used.
  
  
  RESULTS
  Patients with UPS reported a poor QoL. Their QoL was mostly decreased by limitations in functioning due to physical health, and the least by limitations in functioning due to emotional problems. The median of utilities was 0.57, and the mean was 0.58 (SD = .09).The cost for the use of healthcare services was estimated to be €3,123 (SD = €2,952) per patient per year. This cost was enlarged by work-related costs: absence from work (absenteeism), lower on-the-job productivity (presenteeism), and paid substitution of domestic tasks. The resulting mean total cost was estimated to be €6,815 per patient per year.
  
  
  CONCLUSIONS
  These findings suggest that patients with UPS have a high burden of disease and use a considerable amount of healthcare resources. In comparison with other patient groups, the QoL values of patients with UPS were among the poorest and their costs were among the highest of all patient groups. The burden for both patients and society helps to justify the allocation of sufficient resources to effective treatment for patients with UPS.
authors.affiliation: Department of Psychiatry, Section Medical Psychology and Psychotherapy, Erasmus Medical Center, PO Box 2040, 3000, CA Rotterdam, The Netherlands. l.zonneveld@amc.uva.nl.
authors.forename: Lyonne N L
authors.initials: LN
authors.lastname: Zonneveld
authors.forename: Mirjam A G
authors.initials: MA
authors.lastname: Sprangers
authors.forename: Cornelis G
authors.initials: CG
authors.lastname: Kooiman
authors.forename: Adriaan
authors.initials: A
authors.lastname: van 't Spijker
authors.forename: Jan J V
authors.initials: JJ
authors.lastname: Busschbach
mesh_terms: D000041:Absenteeism; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D011788:Quality of Life; D013001:Somatoform Disorders / Q000191:economics* / Q000523:psychology; D011795:Surveys and Questionnaires