中国综合医院躯体形式疾病患者的特征和经济负担:一项多中心横断面研究。

IF 3.6 3区 医学 Q1 PSYCHIATRY Annals of General Psychiatry Pub Date : 2023-08-12 DOI:10.1186/s12991-023-00457-y
Xiangyun Yang, Jia Luo, Pengchong Wang, Yue He, Cong Wang, Lijuan Yang, Jing Sun, Zhanjiang Li
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引用次数: 0

摘要

背景:在中国,躯体形式障碍(SFD)患者经常在综合医院门诊反复就医,增加了不合理的医疗费用。为减少不必要的费用,必须对这些患者进行早期筛查和专科治疗。本研究旨在采用一种新的中文问卷对综合医院SFD患者进行筛查,并探讨这些患者的特点和经济负担。方法:选取3家大型综合医院神经内科、心内科和消化内科门诊患者1497例。采用新编制的躯体症状自筛问卷(SQSS)对参与者进行筛查,以确定SFD患者(SQSS总分≥29分)。我们比较了SFD患者和非SFD患者的人口统计学和临床信息。采用Logistic回归探讨医疗费用、就医次数和病假天数的相关因素。结果:SFD患者的检出率为17.03%。在就业、就诊、症状持续时间、医疗费用、病假天数、PHQ-15评分和PHQ-9评分方面,患有和未患有SFD的患者存在显著差异。SFD患者常出现一般非特异性躯体症状。在回归分析中,有几个潜在因素与较高的医疗费用、反复就诊和病假有关。结论:综上所述,SFD患者在综合医院较为常见,其直接和间接经济负担均高于非SFD患者,应加大对该类患者的筛查力度,及早发现问题。在SFD患者中确定了某些特征和与SFD负面后果相关的几个因素,所有这些都可以通过制定预防性干预计划来预防,以减轻患者的经济负担。
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Characteristics and economic burden of patients with somatoform disorders in Chinese general hospitals: a multicenter cross-sectional study.

Background: In China, patients with somatoform disorders (SFD) often seek medical treatment repeatedly in outpatient clinics of general hospitals, which increases unreasonable medical expenses. It is imperative to provide early screening to these patients and specialized treatment to reduce the unnecessary cost. This study aimed to screen patients with SFD in general hospitals using a new Chinese questionnaire and explore the characteristics and economic burden of these patients.

Methods: Patients (n = 1497) from the outpatient department of neurology, cardiology and gastroenterology of three large general hospitals were included. Participants were screened using a newly developed questionnaire, the Self-screening Questionnaire for Somatic Symptoms (SQSS), to identify the patients with SFD (total SQSS score ≥ 29 points). We compared the demographics and clinical information of patients with and without SFD. Logistic regression was used to explore potential factors related to medical expenses, visits to doctors and sick leave days taken.

Results: The frequency of detection of patients with SFD was 17.03%. There were significant differences in employment, doctor visits, symptom duration, medical expenses, sick leave days, PHQ-15 scores, and PHQ-9 scores between patients with SFD and without SFD. General nonspecific somatic symptoms were frequently present in patients with SFD. Several potential factors were associated with higher medical expenses, repeated doctor visits, and sick leave days taken in the regression analysis.

Conclusion: The findings indicate that patients with SFD are common in general hospitals, and their direct and indirect economic burden is higher than that of non-SFD patients, which indicates that more screening effort should be made to this group to early identify their problems. Certain characteristics were identified among patients with SFD and several factors were associated with negative consequences of SFD, all of which might be prevented by developing a preventive intervention program to reduce the economic burden of the patients.

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来源期刊
CiteScore
6.60
自引率
2.70%
发文量
43
审稿时长
>12 weeks
期刊介绍: Annals of General Psychiatry considers manuscripts on all aspects of psychiatry, including neuroscience and psychological medicine. Both basic and clinical neuroscience contributions are encouraged. Annals of General Psychiatry emphasizes a biopsychosocial approach to illness and health and strongly supports and follows the principles of evidence-based medicine. As an open access journal, Annals of General Psychiatry facilitates the worldwide distribution of high quality psychiatry and mental health research. The journal considers submissions on a wide range of topics including, but not limited to, psychopharmacology, forensic psychiatry, psychotic disorders, psychiatric genetics, and mood and anxiety disorders.
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