scholarly journals Frequent attenders with medically unexplained symptoms: service use and costs in secondary care

2002 ◽  
Vol 180 (3) ◽  
pp. 248-253 ◽  
Author(s):  
Steven Reid ◽  
Simon Wessely ◽  
Tim Crayford ◽  
Matthew Hotopf

BackgroundFrequent attenders in medical settings account for a disproportionate amount of health-care resources. Little is known about service use and costs of secondary care in those frequent attenders presenting with medically unexplained symptoms.AimsTo compare health-care use and costs of patients with medically unexplained symptoms with other frequent attenders in secondary care.MethodIn a sample of 400 frequent attenders of secondary care services, those presenting with medically unexplained symptoms were identified by a review of medical records. Their use of health-care resources was compared with that of other frequent attenders.ResultsOf the frequent attenders 17% had at least two medically unexplained consultation episodes. These patients had a greater number of referrals to secondary care and were more likely to undergo particular investigations.ConclusionsFrequent attenders with medically unexplained symptoms account for levels of service use and expenditure that are comparable with other frequent attenders, but the use and cost of medical investigations in this group are significantly greater.

2003 ◽  
Vol 33 (3) ◽  
pp. 519-524 ◽  
Author(s):  
S. REID ◽  
T. CRAYFORD ◽  
A. PATEL ◽  
S. WESSELY ◽  
M. HOTOPF

Background. There are few longitudinal studies of patients with medically unexplained symptoms. The aim of this study was to investigate outcome in frequent attenders in secondary care who present repeatedly with medically unexplained symptoms.Method. Forty-eight patients presenting with medically unexplained symptoms, from a sample of 61, participated in a 3-year follow-up study. Psychiatric morbidity, functional impairment and use of services were evaluated.Results. At follow-up there was a high prevalence of psychiatric morbidity with 69% having at least one psychiatric diagnosis. The sample continued to be high users of a range of health services and substantial functional impairment was reported.Conclusion. In this group of frequent attenders with medically unexplained symptoms outcome as measured by psychiatric morbidity, service use and functional impairment remained poor after 3 years.


2011 ◽  
Vol 20 (1) ◽  
pp. 30-37 ◽  
Author(s):  
Sarah Schumacher ◽  
Winfried Rief ◽  
Elmar Brähler ◽  
Alexandra Martin ◽  
Heide Glaesmer ◽  
...  

2004 ◽  
Vol 34 (2) ◽  
pp. 195-198 ◽  
Author(s):  
MATTHEW HOTOPF

Countless cross-sectional surveys of primary and secondary care have demonstrated the ubiquitous nature of medically unexplained symptoms. If grouping diverse symptoms under one heading is appropriate, they account for over half of all new presentations in secondary medical care (Nimnuan et al. 2001a) and a sizeable proportion of ‘frequent attenders’ in secondary care have predominantly medically unexplained symptoms (Fink, 1992a; Reid et al. 2002). Such symptoms are costly, persistent, and associated with significant disability and psychiatric disorder (Reid et al. 2001, 2003), but are generally ignored by mental health services (Bass et al. 2001).


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