Health care utilization in patients with non-cardiac chest pain: A longitudinal analysis of chest pain anxiety and interoceptive fear

摘要

Chest pain can be a frightening experience that leads many to seek medical evaluation (). The symptom results in costly health care utilization (). Over half of patients referred for cardiac evaluations of chest pain do not obtain definitive medical explanations for their symptoms; these cases are described as non-cardiac chest pain (NCCP: ). Some patients with NCCP are not reassured after being informed their chest pain is non-cardiac in origin and seek repeated medical evaluation (). Co-morbid anxiety and mood disorders often co-exist with NCCP and are associated with health care utilization (). The current study examined chest pain, general anxiety, interoceptive fear, and health care utilization in a sample of 196 chest pain patients near the time of cardiac evaluation (Time 1), and 70 of these patients one year later (Time 2). Results indicate that anxiety and interoceptive fear were significantly associated with health care utilization at Time 1, and only interoceptive fear (at Time 1) predicted health care utilization at Time 2. This study develops research in this area by examining the relation of anxiety and health care utilization longitudinally in patients with NCCP.