Seo Jun Ho, Han Minkyung, Kang Sunghyuk, Kim Se Joo, Jung Inkyung, Kang Jee In
Department of Psychiatry, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea.
Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
Depress Anxiety. 2024 Nov 28;2024:8352965. doi: 10.1155/da/8352965. eCollection 2024.
Patients with somatic symptom and related disorders (SSRDs) often face diagnostic delays, leading to frustration, unnecessary medical procedures, and excessive costs. This study examines healthcare utilization and costs in the 3 years before diagnosing SSRDs, comparing them to patients with depressive disorders and individuals with no mental disorder using data from the Korean National Health Insurance claims database. The analysis also addresses the influence of medical comorbidities by focusing on patients without them. Utilizing Korean nationwide medical claims database covering all South Koreans, we identified individuals aged 15-64 diagnosed with SSRDs between 2015 and 2019. A corresponding group diagnosed with depression served as controls for nonpsychotic mental disorders. We analyzed medical costs and healthcare utilization comparing the SSRDs group to the depression group and the group with no mental disorder using nonparametric tests, including a specific analysis for those with a Charlson Comorbidity Index (CCI) of zero. The study encompassed 84,223 SSRD patients, 336,919 with depressive disorders, and 269,444 individuals with no mental disorder. Patients with SSRDs had significantly higher healthcare costs and made more frequent use of outpatient and emergency services than both control groups, a pattern consistent even in patients without medical comorbidities. This large nationwide cohort study confirmed that patients with SSRDs frequently used the healthcare system and incurred considerable costs before their diagnosis. The findings suggest that plans for early recognition and intervention, along with mental health support for this population, are urgently needed to assist them and improve the efficiency of the healthcare system.
躯体症状及相关障碍(SSRDs)患者常常面临诊断延迟的问题,这会导致患者沮丧、接受不必要的医疗程序并产生过高费用。本研究利用韩国国民健康保险理赔数据库的数据,考察了SSRDs诊断前3年的医疗服务利用情况及费用,并将其与抑郁症患者和无精神障碍个体进行比较。该分析还通过聚焦于无合并症的患者来探讨医疗合并症的影响。利用覆盖所有韩国人的韩国全国医疗理赔数据库,我们确定了2015年至2019年间年龄在15 - 64岁被诊断为SSRDs的个体。一组相应的被诊断为抑郁症的个体作为非精神病性精神障碍的对照。我们使用非参数检验分析了医疗费用和医疗服务利用情况,将SSRDs组与抑郁症组以及无精神障碍组进行比较,其中包括对Charlson合并症指数(CCI)为零的患者进行的特定分析。该研究纳入了84,223名SSRDs患者、336,919名抑郁症患者以及269,444名无精神障碍个体。SSRDs患者的医疗费用显著更高,且比两个对照组更频繁地使用门诊和急诊服务,即使在无医疗合并症的患者中也是如此。这项大规模的全国队列研究证实,SSRDs患者在诊断前频繁使用医疗系统并产生了相当高的费用。研究结果表明,迫切需要制定早期识别和干预计划,并为这一人群提供心理健康支持,以帮助他们并提高医疗系统的效率。