Characteristics and Resource Utilization of Hospitalized Children With Somatic Symptoms.

Abstract

Objective: To examine patient characteristics and resource utilization of hospitalized children and adolescents with somatic symptom and related disorders (SSRDs).

Patients and methods: This study included 173 patients who were aged 6 to 18 years and admitted to a single, tertiary academic children's hospital between April 2015 and December 2021 with a diagnosis of an SSRD. Sociodemographic information and clinical features were assessed as outcomes. Resource utilization was compared across diagnostic subgroups. Regression analysis was used to determine whether diagnosis predicted length of stay (LOS).

Results: Of the 173 patients included, presenting symptoms were primarily neurologic (n = 109, 63%); the most common diagnostic subgroup was functional neurologic symptom disorder (n = 65, 38%). Resource utilization was notable; the median laboratory studies ordered was 9 (IQR, 4.5-13), 119 of the 173 patients (69%) had at least 1 imaging study, and 124 (72%) had at least 1 physician consultation. The 14-day all-cause emergency department (ED) return rate was 20% (n = 35), and 14-day related ED return rate was 16% (n = 27). After adjustments, LOS was significantly associated with physician-ordered labs (β = 0.32; P = <.001) and consults (β = 0.41; P = <.001).

Conclusion: The findings of this study revealed significant variability in the management of hospitalized patients diagnosed with SSRDs. Future studies to assess the benefit of clinical pathways for SSRDs to standardize management and potentially reduce health care cost by limiting unnecessary evaluation are needed.