Healthcare Utilization and Costs in Patients With Somatic Symptom and Related Disorders Compared With Those With Depression and... 2025 Kang et al

Andy

Andy

Retired committee member
Full title: Healthcare Utilization and Costs in Patients With Somatic Symptom and Related Disorders Compared With Those With Depression and Healthy Controls: A Nationwide Cohort Study

Abstract

Introduction: Patients with somatic symptom and related disorders (SSRDs) often face diagnostic delays, leading to frustration, unnecessary medical procedures, and excessive costs. This study examines healthcare utilization and costs in the 3 years before diagnosing SSRDs, comparing them to patients with depressive disorders and individuals with no mental disorder using data from the Korean National Health Insurance claims database. The analysis also addresses the influence of medical comorbidities by focusing on patients without them.

Methods: Utilizing Korean nationwide medical claims database covering all South Koreans, we identified individuals aged 15–64 diagnosed with SSRDs between 2015 and 2019. A corresponding group diagnosed with depression served as controls for nonpsychotic mental disorders. We analyzed medical costs and healthcare utilization comparing the SSRDs group to the depression group and the group with no mental disorder using nonparametric tests, including a specific analysis for those with a Charlson Comorbidity Index (CCI) of zero.

Results: The study encompassed 84,223 SSRD patients, 336,919 with depressive disorders, and 269,444 individuals with no mental disorder. Patients with SSRDs had significantly higher healthcare costs and made more frequent use of outpatient and emergency services than both control groups, a pattern consistent even in patients without medical comorbidities.

Conclusion: This large nationwide cohort study confirmed that patients with SSRDs frequently used the healthcare system and incurred considerable costs before their diagnosis. The findings suggest that plans for early recognition and intervention, along with mental health support for this population, are urgently needed to assist them and improve the efficiency of the healthcare system.

Open access
 
For the case group, patients with a first principal diagnosis of SSRDs according to ICD-10 codes F45.x (excluding F45.22, F45.3, F45.8) from January 1, 2012, to December 31, 2019 were identified. Exclusions were made to secure diagnostic validity of the case group: F45.3 (somatoform autonomic dysfunction) and F45.8 (other somatoform disorders) were excluded because the two codes were frequently diagnosed by nonpsychiatric clinics. F45.22 (body dysmorphic disorder) was excluded because it is not classified under SSRDs [19]. A washout period of 3 years ensured that patients included had no principal or additional diagnosis of SSRDs at least 3 years prior to the index date. Thus, patients newly diagnosed with SSRDs between 2015 and 2019 were designated as the case group.
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Next they're going to tell us that people eat more when they're hungry, and that it costs more to feed them when they are. Who knew?!

But proposing the current expensive status quo as a solution to costs is impressive in itself. Maybe if we cut all tax rates to zero for people with annual incomes above $1M, this time it will lead to prosperity among the poorest, finally trickle down. Or something like it.
 
rvallee said:
But proposing the current expensive status quo as a solution to costs is impressive in itself. Maybe if we cut all tax rates to zero for people with annual incomes above $1M, this time it will lead to prosperity among the poorest, finally trickle down. Or something like it.
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It reminds me of the saying/joke in urban planning spaces about road traffic “Just one more lane will fix it, I promise” (when it doesn’t really work due to things like bottlenecks and induced demand).

But here’s it’s more like “just one more psychosomatic study” or “just one rehabilitation clinic”.
 
Yann04 said:
It reminds me of the saying/joke in urban planning spaces about road traffic “Just one more lane will fix it, I promise” (when it doesn’t really work due to things like bottlenecks and induced demand).

But here’s it’s more like “just one more psychosomatic study” or “just one rehabilitation clinic”.
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In a similar spirit, I remember once seeing a story about LC clinics, I think it was in the US, that were closing because there was too much demand. It probably wasn't a true reason, which only makes it worse because it means the real reason was even worse than an over-the-top ridiculous one. The real reason was likely that they didn't care about it and assumed, correctly, that no one would be bothered by such a ridiculous reason.

In Psychosomaticland, it's always worse in context, and the more context you add, the worse it is.
 
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