Lamprecht F
Abteilung Psychosomatik und Psychotherapie, Medizinische Hochschule Hannover.
Psychother Psychosom Med Psychol. 1996 Aug;46(8):283-91.
The search for biotechnical causes of diseases although very successful in many areas fail to account for wide variations of morbidity and mortality. Such search in the most common symptoms, for which our health care system is utilized, falls short of meeting the health needs of a vast number of patients, since only in 16% such causes can be found. This continuing misunderstanding contributes to the tremendous rise in healthcare expenditures without improving the delivered health care. Relatively short lasting psychosocial interventions are shown to have a significant effect in reducing health care seeking behaviour. This is particular demonstrated in somatization disorder. In the last section examples for cost offset effects in outpatient care and in psychosomatic inpatient treatment will be given with remarkable cost savings. Finally recommendations are listed to meet the health needs of the public more sufficiently. Psychosocial factors are shared determinants of health outcomes across diseases, therefore labeled as "Super highways for Disease", must be taken into account to reduce the number of unnecessary diagnostic examinations and unsuccessful treatments, to reduce the length of hospital stay, to increase the survival rate in cancer by increasing the self-management and self-competence, which will finally lead to a tremendous reduction in costs for our health care system.
对疾病生物医学原因的探寻尽管在许多领域非常成功，但却无法解释发病率和死亡率的广泛差异。在我们利用医疗保健系统应对的最常见症状方面进行的此类探寻，未能满足大量患者的健康需求，因为只有16%的此类病因能够被找到。这种持续的误解导致医疗保健支出大幅上升，却没有改善所提供的医疗保健服务。相对短期的社会心理干预已被证明在减少就医行为方面有显著效果。这在躯体化障碍中表现得尤为明显。在最后一部分，将给出门诊护理和心身疾病住院治疗中成本抵消效应的例子，显示出显著的成本节约。最后列出了一些建议，以更充分地满足公众的健康需求。社会心理因素是各种疾病健康结果的共同决定因素，因此被称为“疾病的超级高速公路”，必须加以考虑，以减少不必要的诊断检查和无效治疗的数量，缩短住院时间，通过提高自我管理和自我能力来提高癌症患者的生存率，这最终将大幅降低我们医疗保健系统的成本。
