Psychosocial assessment and health care utilization after coronary bypass surgery

This study examines the relationship between psychosocial stress and social support before coronary surgery and the amount of health care utilization in a sample of 136 patients during postoperative hospitalization. The aim of the study is to test the hypothesis that there is a correlation between a high psychosocial stress profile and the utilization of medical c are (so called high utilizers). The sample consists of 80.7% men and 19,3% women aged between 31 and 78 years (mean 64; sd 9,1). In this first data an alysis psychosocial impact is assessed by anxiety, depression and social su pport (HADS-D, F-SOZU). Detailed somatic factors concerning severity of the illness, inpatient course and the utilization of health care (medication, technical examinations, consultations) are assessed by means of a documenta tion system. With regard to anxiety, depression and social support the sample is located within the normal range. In contrast to our expectations the results show that high scores of anxiety and depression as well as a low level of emotio nal support do not correlate significantly with an increased use of medicat ion, the number of consultations and technical examinations. Furthermore no correlation has been found between the length of hospitalization and preop erative comorbidity as compared to the mentioned psychosocial stress variab les. On the other hand the data analysis showed that about 30% of the patients d uring the postoperative period utilize about half of the total amount of th e different medical treatments. In the postoperative period these high util izers cannot be distinguished from the other patients, neither by sociodemo graphic variables nor by means of an increased psychosocial stress or sever ity of illness.