Katerndahl D A, Realini J P
Department of Family Practice, University of Texas Health Science Center at San Antonio 78284, USA.
Psychiatr Serv. 1997 Aug;48(8):1027-32. doi: 10.1176/ps.48.8.1027.
Patients with panic symptoms are heavy users of the health care system, although many do not seek care specifically for those symptoms. This study documents utilization of various sources of health care of subjects with panic symptoms, including those who met criteria for panic disorder and those with infrequent panic, distinguishing between use specifically for panic symptoms and use for reasons not related to panic.
This community-based sample, predominantly Mexican American and female, included 97 subjects with panic symptoms and 97 matched control subjects with no panic symptoms. Data were collected on two-month utilization of various sources of health care both within and outside the mainstream health care system, barriers to access to care, and levels of medical insurance coverage.
Subjects with panic symptoms had higher utilization rates for the services of psychiatrists and psychologists and for ambulance services than control subjects. Subjects who met criteria for panic disorder and who sought care specifically for panic symptoms generally accounted for the differences between the group with panic symptoms and the control group. The two groups differed little in barriers to access, but the control group reported that their medical insurance covered more types of services.
Compared with control subjects, subjects with panic symptoms reported higher rates of health care utilization despite having less insurance coverage and experiencing similar barriers to access. The higher rate was due to increased utilization of health care by subjects who met criteria for panic disorder and to help seeking specifically for symptoms of panic.
有惊恐症状的患者是医疗保健系统的高使用者，尽管许多人并非专门为这些症状寻求治疗。本研究记录了有惊恐症状的受试者对各种医疗保健资源的利用情况，包括符合惊恐障碍标准的受试者和惊恐发作不频繁的受试者，区分了专门针对惊恐症状的利用和与惊恐无关的利用。
这个以社区为基础的样本主要是墨西哥裔美国女性，包括97名有惊恐症状的受试者和97名匹配的无惊恐症状的对照受试者。收集了关于主流医疗保健系统内外各种医疗保健资源的两个月利用情况、获得医疗服务的障碍以及医疗保险覆盖水平的数据。
有惊恐症状的受试者在精神科医生和心理医生服务以及救护车服务方面的利用率高于对照受试者。符合惊恐障碍标准且专门为惊恐症状寻求治疗的受试者通常造成了有惊恐症状组和对照组之间的差异。两组在获得医疗服务的障碍方面差异不大，但对照组报告其医疗保险覆盖的服务类型更多。
与对照受试者相比，有惊恐症状的受试者尽管保险覆盖范围较小且在获得医疗服务方面遇到类似障碍，但报告的医疗保健利用率更高。较高的利用率是由于符合惊恐障碍标准的受试者增加了医疗保健利用以及专门为惊恐症状寻求帮助。
