Hartz A, Damiano PC, Bentler SE, Willard JC, Momany ET; Association for Health Services Research. Meeting.

Abstr Book Assoc Health Serv Res Meet. 1999; 16: 339-40.

Public Policy Center and Department of Preventive and Community Dentistry, The University of Iowa, Iowa City 52242, USA.

RESEARCH OBJECTIVE: Somatoform symptoms, physical symptoms with no discernable organic basis, represent an important component of primary medical care. The present study evaluated the competence of primary care physicians to help patients with these symptoms. STUDY DESIGN: Two sources of data were used: 1) 280 respondents to a stratified random sample of 1121 primary care physicians in Iowa, 2) 439 respondents to a random sample of 984 adult Medicaid enrollees. Physician respondents in the first data set estimated the frequency of somatoform symptoms in their patients and their competent and satisfaction in helping patients with these symptoms. Patient respondents in the second data set reported on the presence of each of six somatoform symptoms and their perception of their physicians' concern with each of these symptoms. Patients were considered to have a somatoform symptom if they usually had the symptom even though they were healthy in other ways. Only the 325 patients in generally good health were used for the analysis. PRINCIPAL FINDINGS: The median percentage of patients with somatoform symptoms estimated by physicians was 10% with the 10th to 90th percentile range of 3 to 30%. This percentage was much lower than the 38% of patients generally in good health who reported having at least one of six somatoform symptoms. Twenty-five percent of the physicians reported that they provided very good care to patients with somatoform symptoms, and 52% of the patients with somatoform symptoms believed that their physicians were very concerned about these problems. Physicians with a greater likelihood of providing very good patient care had higher estimates of the percentage of patients with somatoform symptoms (p=0.02), had greater satisfaction in managing somatoform symptoms (p=-.0001), had greater satisfaction in managing purely psychological problems (p=0.0001), were in solo practice (p<0.005), or had been in the same location for at least five years (p=.04). CONCLUSIONS: These results suggest that physicians underestimate the percentage of patients with somatoform symptoms and are uncomfortable providing care to these patients. The physicians likely to provide the best care for these patients are more sensitive to the presence of these symptoms, get greater satisfaction from managing these problems, and are in better position to develop a close association with their patients. RELEVANCE TO CLINICAL PRACTICE AND POLICY: The results demonstrate an unmet need for the clinical management of Medicaid patients with somatoform symptoms.

Publication Types:

• Meeting Abstracts

Keywords:

• Adult
• Data Collection
• Humans
• Iowa
• Mental Competency
• Patient Care
• Personal Satisfaction
• Physicians
• Physicians, Family
• Primary Health Care
• diagnosis
• hsrmtgs

Other ID:

• HTX/20602372

UI: 102194061

From Meeting Abstracts