HEALTH-CARE UTILIZATION OF SOMATIZING PATIENTS IN A PULMONARY SUBSPECIALTY CLINIC

Somatizing patients present with medically unexplained physical compla ints, repeat clinic visits, and a history of prior extensive testing. The authors reviewed 1,908 pulmonary consultation reports for 1990-199 1 for evidence of somatization, yielding a group of 41 (2%) patients f or study. Billing records were obtained and were compared to asthmatic patients and those in a health maintenance organization (HMO). Health care costs for the somatizing patients were significantly higher than the average cost for HMO patients and comparable to the health costs for patients with asthma. Half of the somatizing patients had psycholo gical problems indicated in their medical records, but few received ps ychiatric referral or treatment. Management of the somatizing patient within the specialty clinic and on-site psychiatric treatment are sugg ested as ways to decrease unnecessary health care utilization.