Rost K, Kashner T M, Smith R G
NIMH Center for Rural Mental Healthcare Research Little Rock, Arkansas.
Gen Hosp Psychiatry. 1994 Nov;16(6):381-7. doi: 10.1016/0163-8343(94)90113-9.
In order to determine the health effects of an intervention that reduces the cost of care for somatization disorder (SD) patients, 59 primary care physicians were randomized to receive a psychiatric consultation letter providing treatment recommendations for 73 patients either at baseline or the end of the year-long study. Seventy of these patients (96%) were followed every 4 months for 1 year by a research assistant blind to randomization. A year following the intervention, patients of experimental physicians reported greater physical capacity than patients of control physicians (mean difference = 17.9, 95% CI 1.0-34.9) with a $466 reduction (95% CI $132-$699) in health care charges. In addition to a net 21% reduction in health care charges for the typical SD patient, the consultation letter improved physical functioning in a group of highly impaired subjects.
为了确定降低躯体化障碍（SD）患者护理成本的干预措施对健康的影响，59名初级保健医生被随机分组，在基线期或为期一年的研究结束时收到一份精神科会诊信，其中为73名患者提供了治疗建议。这些患者中有70名（96%）由对随机分组不知情的研究助理每4个月随访1年。干预一年后，实验组医生的患者报告的身体能力高于对照组医生的患者（平均差异=17.9，95%置信区间1.0-34.9），医疗费用降低了466美元（95%置信区间132美元-699美元）。除了典型SD患者的医疗费用净降低21%外，会诊信还改善了一组严重受损受试者的身体功能。
