Somatisation Scores Associated With Healthcare Costs and Utilisation in a Sample of Emergency Department Patients

OBJECTIVES: Somatic Symptom and Related Disorders (SSRD) are associated with frequent healthcare utilisation and elevated costs, yet their impact within Emergency Departments (EDs) remains underexplored. This study investigates the relationship between somatisation score and healthcare utilisation and costs in an Australian ED setting. DESIGN: Retrospective cohort study. SETTING: A tertiary public hospital ED in Australia serving metropolitan and rural populations. Healthcare utilisation and cost data were extracted from the local network's Activity Based Management database for 3.5 financial years preceding the index presentation. PARTICIPANTS: 375 ED patients aged 18-70 years screened using the PHQ-15 and WI-7 tools over a two-week period. Participants were classified as high or low somatisers using dynamic cutoffs. Total available healthcare costs and occasions of service over the 42 months preceding the index ED presentation were gathered. Negative binomial regression models were used to identify predictors of total costs and service occasions. RESULTS: High somatisers (59.84% of the sample) incurred significantly greater healthcare costs (mean AUD $23,713 vs. $10,392) and service occasions (mean 38.7 vs. 18.7) than low somatisers. regression analyses identified somatisation severity, age and female sex as significant predictors of increased healthcare utilisation and costs. Presentation-based variables such as triage category and diagnosis were not significant predictors. CONCLUSIONS: High somatisation scores are strongly associated with increased healthcare utilisation and costs in ED patients. These findings suggest that SSRD may be a previously neglected factor in hospital resource planning. Early identification and appropriate management of SSRD in EDs could yield substantial economic and clinical benefits.