Do Psychological and Social Factors Correspond with Health Care Utilization?

Background: There is evidence that unhelpful thoughts and distress regarding symptoms are associated with more frequent care utilization. Among people seeing a musculoskeletal specialist in person, we sought relationships between mental and social health factors and the number of 1) self-reported in-person healthcare contacts, 2) remote healthcare contacts, and 3) total healthcare contacts during the 6-week period prior to the visit. Methods: We enrolled 148 adult patients in a cross-sectional study of people visiting a musculoskeletal specialist for a new or return visit. Patients indicated the number of self-reported remote and in-person healthcare contacts, and completed measures of social health, unhelpful thoughts regarding symptoms, general distress, and demographics. Results: Accounting for potential confounding in multivariable analysis, more pre-visit self-reported in-person care episodes were independently associated with more unhelpful thoughts about symptoms [higher score on Negative Pain Thoughts Questionnaire (NPTQ), regression coefficient: 0.05, P < 0.05] and household income between $15000 and $29999 or $30000 and $49999. No factors were associated with the total number of pre-visit remote and in-person care contacts. Conclusion: The observation that patients with greater unhelpful thinking seek out more in-person care episodes for musculoskeletal symptoms supports the concept that comprehensive care strategies attentive to common unhelpful thoughts regarding symptoms could limit resource utilization.