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Analysis of Medically Unspecified Disease in the General Outpatient Department of a Comprehensive Tertiary Hospital

Received: 20 September 2024     Accepted: 26 October 2024     Published: 31 October 2024
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Abstract

Background Patients with medically unspecified disease (MUD) may present at any disease stage, with clinical manifestations and test results that do not lead to a clear diagnosis, posing a common challenge in clinical settings. General practitioners, with their patient-centered approach and holistic medical models, have an advantage in diagnosing and treating MUD. Standardizing the diagnosis and treatment of MUD is a crucial skill for general practitioners. However, there is currently a lack of data on the treatment of MUD in general outpatient clinics of comprehensive tertiary hospitals. Objective This study examines the prevalence of medically unexplained symptoms (MUS) in general outpatient clinics, offering insights for general practitioners in tertiary hospitals on diagnosing and treating MUS. It also serves as a foundation for standardizing the diagnostic and treatment protocols for MUD. Methods Select patients diagnosed with medically unspecified disease (MUD) who visited the outpatient department of our general medicine department between September 2021 and September 2022. Collect basic information and follow-up data for one year post-visit, and analyze the reasons for the initial visit and subsequent follow-up outcomes. Results A total of 576 patients with MUD received treatment at the general outpatient department, with an average age of (44.97 ± 13.50) years. There was no statistically significant difference in the age distribution among male and female MUD patients (P > 0.05). Chest pain was the most common reason for treatment of medically unspecified disease in the general outpatient department. Among patients treated for chest pain, there were more males than females (P < 0.05), and a greater number of patients were treated in specialized clinics compared to general clinics (P < 0.05), The majority of patients remained undiagnosed and had either 0 or no more than 2 visits within a year. There was no significant correlation between anxiety scores and age, although female patients, those with chest pain, healthcare staff, and non-smokers reported higher levels of self-anxiety. Conclusion MUD patients have various reasons for seeking medical treatment. General practitioners in comprehensive tertiary hospitals should make full use of relevant resources, attach importance to the full evaluation of the psychological status of MUD patients, standardize the diagnosis and treatment process of MUD, and provide more comprehensive diagnosis and treatment services.

Published in American Journal of Clinical and Experimental Medicine (Volume 12, Issue 4)
DOI 10.11648/j.ajcem.20241204.11
Page(s) 45-51
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Medically Unspecified Disease, Comprehensive Tertiary Hospitals, General Practice, Medical Treatment, Anxiety Score

References
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[2] Gol, J., Terpstra, T., Lucassen, P., Houwen, J., van Dulmen, S., Olde Hartman, T. C., & Rosmalen, J. 2019. Symptom management for medically unexplained symptoms in primary care: a qualitative study. The British journal of general practice: the journal of the Royal College of General Practitioners 69: e254–e261.
[3] Zhou YF, Fang LZ, Yu DH, Ma L, Wang LY & Feng M. 2021. The orientation and development strategy of general medicine in general hospital [J]. Chinese General Medicine 13: 1581-1584+1591.
[4] Pan Q, Ren JJ, Zhang M, Yin ZX, He Q, Yao CJ & Wang Z. 2023. How does undifferentiated disease resonate with general practice at the same frequency? [J]. Chinese General Medicine 31: 3877-3883.
[5] Hilderink, P. H., Collard, R., Rosmalen, J. G., & Oude Voshaar, R. C. 2013. Prevalence of somatoform disorders and medically unexplained symptoms in old age populations in comparison with younger age groups: a systematic review. Ageing research reviews 12: 151–156.
[6] Baitha, U., Deb, K. S., Ranjan, P., Mukherjee, A., Bauddh, N. K., Kaloiya, G. S., Kumar, A., & Jadon, R. S. 2019. Estimated prevalence of medically unexplained physical symptoms in the medicine outpatient department of a tertiary care hospital in India. General hospital psychiatry 61: 47–52.
[7] Pu, J., & Zhang, J. 2018. Study on the influencing factors of depression and anxiety in elderly patients with chronic diseases [J]. Journal of Community Medicine 16: 1701-1704.
[8] Zhou ZH, Huang WJ, Chen SY, Guo JZ & Jin SH. 2012. Study on the causes and diagnosis of general practice outpatients in tertiary general hospital [J]. Chinese General Medicine 23: 2652-2655.
[9] Probst, J. C., Moore, C. G., Baxley, E. G., & Lammie, J. J. 2002. Rural-urban differences in visits to primary care physicians. Family medicine 34: 609–615.
[10] Svansdottir, E., Hreggvidsdottir, S., Sigurdardottir, B., Benedikz, E., Andersen, K., & Karlsson, H. D. 2018. Non-cardiac chest pain and its association with persistent chest pain and poor mental well-being. Laeknabladid 104: 71–77.
[11] De Wolff, J. F., & Fawcett, K. M. 2019. Non-Cardiac Chest Pain. Acute medicine 18: 260.
[12] Wang RY, Li F, Zhi X, He ZY, Wang Y, Zhao WW & Zhang M. 2016. Orientation and development of general practice department of general hospital in hierarchical diagnosis and treatment based on disease spectrum of outpatients [J]. Chinese General Practice 19: 3417-3421.
[13] Qu S, Shi XX, Xie ZJ, Ding RJ, & Zheng MJ. 2021. Validity and reliability of patient health questionnaire and generalized anxiety disorder scale for screening depression and anxiety in non-cardiac chest pain patients. Chinese Journal of Mental Health 35: 376, 381.
[14] Zhao WW, Wang RY, Zhang JJ, Wang YY, Zhang YL & Sun YJ. 2019. Comparative study on visit status of patients with medically unexplained physical symptoms from general practice ward and specialist ward in general hospitals. [J]. Chinese General Practice 22: 20-23.
[15] Liu GQ, Chen ZG. 1997. Survey of smoking cessation anxiety and discussion of countermeasures. [J]. Journal of North Sichuan Medical College 1997: 62-63.
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    Xu, S., Liu, J., Chen, Y., Zhang, Q. (2024). Analysis of Medically Unspecified Disease in the General Outpatient Department of a Comprehensive Tertiary Hospital. American Journal of Clinical and Experimental Medicine, 12(4), 45-51. https://doi.org/10.11648/j.ajcem.20241204.11

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    ACS Style

    Xu, S.; Liu, J.; Chen, Y.; Zhang, Q. Analysis of Medically Unspecified Disease in the General Outpatient Department of a Comprehensive Tertiary Hospital. Am. J. Clin. Exp. Med. 2024, 12(4), 45-51. doi: 10.11648/j.ajcem.20241204.11

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    AMA Style

    Xu S, Liu J, Chen Y, Zhang Q. Analysis of Medically Unspecified Disease in the General Outpatient Department of a Comprehensive Tertiary Hospital. Am J Clin Exp Med. 2024;12(4):45-51. doi: 10.11648/j.ajcem.20241204.11

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  • @article{10.11648/j.ajcem.20241204.11,
      author = {Shuang Xu and Jing Liu and Yun Chen and Qing Zhang},
      title = {Analysis of Medically Unspecified Disease in the General Outpatient Department of a Comprehensive Tertiary Hospital
    },
      journal = {American Journal of Clinical and Experimental Medicine},
      volume = {12},
      number = {4},
      pages = {45-51},
      doi = {10.11648/j.ajcem.20241204.11},
      url = {https://doi.org/10.11648/j.ajcem.20241204.11},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajcem.20241204.11},
      abstract = {Background Patients with medically unspecified disease (MUD) may present at any disease stage, with clinical manifestations and test results that do not lead to a clear diagnosis, posing a common challenge in clinical settings. General practitioners, with their patient-centered approach and holistic medical models, have an advantage in diagnosing and treating MUD. Standardizing the diagnosis and treatment of MUD is a crucial skill for general practitioners. However, there is currently a lack of data on the treatment of MUD in general outpatient clinics of comprehensive tertiary hospitals. Objective This study examines the prevalence of medically unexplained symptoms (MUS) in general outpatient clinics, offering insights for general practitioners in tertiary hospitals on diagnosing and treating MUS. It also serves as a foundation for standardizing the diagnostic and treatment protocols for MUD. Methods Select patients diagnosed with medically unspecified disease (MUD) who visited the outpatient department of our general medicine department between September 2021 and September 2022. Collect basic information and follow-up data for one year post-visit, and analyze the reasons for the initial visit and subsequent follow-up outcomes. Results A total of 576 patients with MUD received treatment at the general outpatient department, with an average age of (44.97 ± 13.50) years. There was no statistically significant difference in the age distribution among male and female MUD patients (P > 0.05). Chest pain was the most common reason for treatment of medically unspecified disease in the general outpatient department. Among patients treated for chest pain, there were more males than females (P < 0.05), and a greater number of patients were treated in specialized clinics compared to general clinics (P < 0.05), The majority of patients remained undiagnosed and had either 0 or no more than 2 visits within a year. There was no significant correlation between anxiety scores and age, although female patients, those with chest pain, healthcare staff, and non-smokers reported higher levels of self-anxiety. Conclusion MUD patients have various reasons for seeking medical treatment. General practitioners in comprehensive tertiary hospitals should make full use of relevant resources, attach importance to the full evaluation of the psychological status of MUD patients, standardize the diagnosis and treatment process of MUD, and provide more comprehensive diagnosis and treatment services.
    },
     year = {2024}
    }
    

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  • TY  - JOUR
    T1  - Analysis of Medically Unspecified Disease in the General Outpatient Department of a Comprehensive Tertiary Hospital
    
    AU  - Shuang Xu
    AU  - Jing Liu
    AU  - Yun Chen
    AU  - Qing Zhang
    Y1  - 2024/10/31
    PY  - 2024
    N1  - https://doi.org/10.11648/j.ajcem.20241204.11
    DO  - 10.11648/j.ajcem.20241204.11
    T2  - American Journal of Clinical and Experimental Medicine
    JF  - American Journal of Clinical and Experimental Medicine
    JO  - American Journal of Clinical and Experimental Medicine
    SP  - 45
    EP  - 51
    PB  - Science Publishing Group
    SN  - 2330-8133
    UR  - https://doi.org/10.11648/j.ajcem.20241204.11
    AB  - Background Patients with medically unspecified disease (MUD) may present at any disease stage, with clinical manifestations and test results that do not lead to a clear diagnosis, posing a common challenge in clinical settings. General practitioners, with their patient-centered approach and holistic medical models, have an advantage in diagnosing and treating MUD. Standardizing the diagnosis and treatment of MUD is a crucial skill for general practitioners. However, there is currently a lack of data on the treatment of MUD in general outpatient clinics of comprehensive tertiary hospitals. Objective This study examines the prevalence of medically unexplained symptoms (MUS) in general outpatient clinics, offering insights for general practitioners in tertiary hospitals on diagnosing and treating MUS. It also serves as a foundation for standardizing the diagnostic and treatment protocols for MUD. Methods Select patients diagnosed with medically unspecified disease (MUD) who visited the outpatient department of our general medicine department between September 2021 and September 2022. Collect basic information and follow-up data for one year post-visit, and analyze the reasons for the initial visit and subsequent follow-up outcomes. Results A total of 576 patients with MUD received treatment at the general outpatient department, with an average age of (44.97 ± 13.50) years. There was no statistically significant difference in the age distribution among male and female MUD patients (P > 0.05). Chest pain was the most common reason for treatment of medically unspecified disease in the general outpatient department. Among patients treated for chest pain, there were more males than females (P < 0.05), and a greater number of patients were treated in specialized clinics compared to general clinics (P < 0.05), The majority of patients remained undiagnosed and had either 0 or no more than 2 visits within a year. There was no significant correlation between anxiety scores and age, although female patients, those with chest pain, healthcare staff, and non-smokers reported higher levels of self-anxiety. Conclusion MUD patients have various reasons for seeking medical treatment. General practitioners in comprehensive tertiary hospitals should make full use of relevant resources, attach importance to the full evaluation of the psychological status of MUD patients, standardize the diagnosis and treatment process of MUD, and provide more comprehensive diagnosis and treatment services.
    
    VL  - 12
    IS  - 4
    ER  - 

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