TY - JOUR
KW - Adult
KW - Aged
KW - Anxiety/therapy
KW - Attitude of Health Personnel
KW - Depression/therapy
KW - Fatigue/therapy
KW - Female
KW - Headache/therapy
KW - Health Care Costs
KW - Humans
KW - Male
KW - Mental Health
KW - Middle Aged
KW - Pilot Projects
KW - Primary Health Care/economics/utilization
KW - Referral and Consultation/economics/utilization
KW - Somatoform Disorders/therapy
KW - United States
AU - A. Matalon
AU - T. Nahmani
AU - S. Rabin
AU - B. Maoz
AU - J. Hart
A1 - 
AB - BACKGROUND: Frequent attenders in primary care are a professional challenge for family physicians, and the medical costs of their care can be very high. Some of them suffer from somatization and are concerned solely with their physical complaints, although somatic complaints are the most common presentation of anxiety and depression. To assess and treat these patients comprehensively, a multidisciplinary clinic was created in the community. METHODS: This study describes the first 40 patients referred to the clinic. All patients completed a mental health screening questionnaire and a functional assessment of health. The utilization of medical resources was assessed by chart review for the year before and the year after the first encounter in the clinic. The intervention consisted of a comprehensive bio-psychosocial consultation where life history and medical symptoms were woven together into a new narrative. The intervention also included pharmacological treatment and short-term psychological interventions. RESULTS: The majority of referred patients were women and their average age was 52 years. Headache was the leading symptom, followed by fatigue. The mean number of reported symptoms for each individual patient was 10. Mental health problems were mainly somatization, depression and anxiety. The average yearly costs per person of US$4035 were reduced to US$1161 the year following referral. CONCLUSIONS: The integrated approach of the clinic satisfied at least three needs: of the patient, of the referring physician and of the health maintenance organization. The results of this uncontrolled pilot study suggest that this intervention helped to modify illness behaviour, decreasing the costs of medical investigations.
BT - Family practice
C5 - Financing & Sustainability; Medically Unexplained Symptoms
CP - 3
CY - England
IS - 3
JF - Family practice
N2 - BACKGROUND: Frequent attenders in primary care are a professional challenge for family physicians, and the medical costs of their care can be very high. Some of them suffer from somatization and are concerned solely with their physical complaints, although somatic complaints are the most common presentation of anxiety and depression. To assess and treat these patients comprehensively, a multidisciplinary clinic was created in the community. METHODS: This study describes the first 40 patients referred to the clinic. All patients completed a mental health screening questionnaire and a functional assessment of health. The utilization of medical resources was assessed by chart review for the year before and the year after the first encounter in the clinic. The intervention consisted of a comprehensive bio-psychosocial consultation where life history and medical symptoms were woven together into a new narrative. The intervention also included pharmacological treatment and short-term psychological interventions. RESULTS: The majority of referred patients were women and their average age was 52 years. Headache was the leading symptom, followed by fatigue. The mean number of reported symptoms for each individual patient was 10. Mental health problems were mainly somatization, depression and anxiety. The average yearly costs per person of US$4035 were reduced to US$1161 the year following referral. CONCLUSIONS: The integrated approach of the clinic satisfied at least three needs: of the patient, of the referring physician and of the health maintenance organization. The results of this uncontrolled pilot study suggest that this intervention helped to modify illness behaviour, decreasing the costs of medical investigations.
PP - England
PY - 2002
SN - 0263-2136; 0263-2136
SP - 251
EP - 256
EP - 
T1 - A short-term intervention in a multidisciplinary referral clinic for primary care frequent attenders: description of the model, patient characteristics and their use of medical resources
T2 - Family practice
TI - A short-term intervention in a multidisciplinary referral clinic for primary care frequent attenders: description of the model, patient characteristics and their use of medical resources
U1 - Financing & Sustainability; Medically Unexplained Symptoms
U2 - 11978715
VL - 19
VO - 0263-2136; 0263-2136
Y1 - 2002
ER -