- 作者：Alex ; er Konnopka ; Claudia Kaufmann ; Hans-Helmut K?nig ; Dirk Heider ; Beate Wild ; Joachim Szecsenyi ; Wolfgang Herzog ; Sven Heinrich ; Rainer Schaefert
- 关键词：Medically unexplained symptoms ; Somatoform disorder ; Somatic symptom severity ; Direct cost ; Indirect cost
- 刊名：Journal of Psychosomatic Research
- 出版年：2013
- 出版时间：October, 2013
- 年：2013
- 卷：75
- 期：4
- 页码：370-375
- 全文大小：253 K
Objective
To analyse the association of direct and indirect costs in patients with medically unexplained symptoms (MUS) with somatic symptom severity (SSS).Methods
A cross-sectional cost analysis for retrospective 6 months was conducted in 294 primary care patients with MUS. Health care utilisation and loss of productivity were measured by questionnaires. SSS was measured using the ¡°Patient Health Questionnaire 15¡± (PHQ-15). Direct and indirect costs and the association of costs with SSS were analysed via multiple linear regression analysis.
Results
Patients with MUS had average 6-month direct costs of 1098 EUR and indirect costs of 7645 EUR. For direct costs, outpatient physician visits were the most expensive single cost category (36 % ), followed by pharmaceuticals (25 % ) and hospital stays (19 % ). Indirect costs were predominantly caused by productivity reduction at work (56 % ) followed by early retirement (29 % ) and acute sickness absence (14 % ). As compared to mild SSS, moderate SSS was not significantly associated with direct, but with indirect costs (+ 2948 EUR; p < .001); severe SSS was associated with increased direct cost (+ 658 EUR; p = .001) and increased indirect costs (+ 4630 EUR; p < .001). Age was positively associated with direct cost (+ 15 EUR for each additional year; p = .015) as well as indirect cost (+ 104 EUR for each additional year; p < .001).
Conclusions
MUS are associated with relevant direct and even much higher indirect costs that strongly depend on SSS.