Fink P
Institute of Psychiatric Demography, Aarhus Psychiatric Hospital, Risskov, Denmark.
Gen Hosp Psychiatry. 1993 Jul;15(4):211-8. doi: 10.1016/0163-8343(93)90035-m.
Persistent somatization patients put a serious burden on the health care system with multiple admissions, tests, surgeries, and medications. This study reports on factors relevant to the health-seeking behavior of somatizing patients and aspects of the health care system that facilitate their overutilization of health resources. Individuals (age 17-49 years) from the general population of two Danish municipalities with at least 10 general admissions during an 8-year period were studied comparing persistent somatizers with other high utilizers of medical admissions. Results are reported on geographical mobility, change in family doctors, route and distribution of admissions by time of day or week, discharges against medical advice, physical disease overlooked, and distribution of admissions to specialties. Although the health-seeking behavior of persistent somatizers may in part explain their overutilization of health care resources, such overutilization could be reduced and much suffering avoided if physicians displayed the same enthusiasm in diagnosing somatization as in ruling out organic pathology.
持续性躯体化障碍患者因多次住院、检查、手术和用药给医疗保健系统带来了沉重负担。本研究报告了与躯体化障碍患者求医行为相关的因素以及导致他们过度使用医疗资源的医疗保健系统方面的情况。对来自丹麦两个自治市普通人群中年龄在17至49岁之间、在8年期间至少有10次普通住院记录的个体进行了研究,将持续性躯体化障碍患者与其他高住院率使用者进行了比较。报告了地理流动性、家庭医生的更换情况、按白天或一周中的时间划分的住院途径和分布、违背医嘱出院、被忽视的躯体疾病以及各专科的住院分布情况。尽管持续性躯体化障碍患者的求医行为可能部分解释了他们对医疗保健资源的过度使用,但如果医生在诊断躯体化障碍时能像排除器质性病变时一样充满热情,那么这种过度使用是可以减少的,许多痛苦也可以避免。