Do Psychological and Social Factors Correspond with Health Care Utilization?

Sina Ramtin; Amirreza Fatehi; David Ring; Sean Gallagher; Anthony Johnson

doi:10.18502/jost.v10i2.15512

Sina Ramtin Research Fellowship, Department of Surgery and Perioperative Care, Dell Medical School, The University of Texas at Austin, Austin, Texas, USA
Amirreza Fatehi Hand Clinical Fellowship, Department of Surgery and Perioperative Care, Dell Medical School, The University of Texas at Austin, Austin, Texas, USA
David Ring Professor, Department of Surgery and Perioperative Care, Dell Medical School, The University of Texas at Austin, Austin, Texas, USA
Sean Gallagher Department of Surgery and Perioperative Care, Dell Medical School, The University of Texas at Austin, Austin, Texas, USA
Anthony Johnson Associate Professor, Department of Surgery and Perioperative Care, Dell Medical School, The University of Texas at Austin, Austin, Texas, USA

DOI: https://doi.org/10.18502/jost.v10i2.15512

Keywords: Health Care Utilization; Psychological Factors; Social Factors

Abstract

Background: There is evidence that unhelpful thoughts and distress regarding symptoms are associated with more frequent care utilization. Among people seeing a musculoskeletal specialist in person, we sought relationships between mental and social health factors and the number of 1) self-reported in-person healthcare contacts, 2) remote healthcare contacts, and 3) total healthcare contacts during the 6-week period prior to the visit.

Methods: We enrolled 148 adult patients in a cross-sectional study of people visiting a musculoskeletal specialist for a new or return visit. Patients indicated the number of self-reported remote and in-person healthcare contacts, and completed measures of social health, unhelpful thoughts regarding symptoms, general distress, and demographics.

Results: Accounting for potential confounding in multivariable analysis, more pre-visit self-reported in-person care episodes were independently associated with more unhelpful thoughts about symptoms [higher score on Negative Pain Thoughts Questionnaire (NPTQ), regression coefficient: 0.05, P < 0.05] and household income between $15000 and $29999 or $30000 and $49999. No factors were associated with the total number of pre-visit remote and in-person care contacts.

Conclusion: The observation that patients with greater unhelpful thinking seek out more in-person care episodes for musculoskeletal symptoms supports the concept that comprehensive care strategies attentive to common unhelpful thoughts regarding symptoms could limit resource utilization.