Who benefits from multidisciplinary care in functional somatic disorders? Identifying cost-effective patient selection through diagnostic classification groups

Background: Functional Somatic Disorders (FSD) significantly impact patients’ quality of life while placing a substantial economic burden on healthcare systems. Identifying which patients achieve reductions in healthcare costs through multidisciplinary care remains crucial for optimizing resource allocation. Methods: A retrospective analysis examined healthcare utilization and costs during the year preceding and the year following patients’ initiation of treatment at a specialized, multidisciplinary clinic in Israel. The clinic combined medical care with mind-body therapies - including cognitive behavioral therapy, hypnotherapy, and physiotherapy. Using baseline characteristics, patients were divided into Diagnostic Classification Groups (DCG). A multivariable analysis was performed to ascertain the impact of DCG on annual, average changes in healthcare utilization and costs after treatment. Results: Data from N = 685 patients were analyzed. Reduced healthcare utilization and costs were observed among approximately 56% of the population receiving multidisciplinary care. Mean annual cost reductions were 1,367 ILS per patient. Specifically, significant reductions were observed in hospitalizations (-1,723 ILS) and diagnostic procedures (-495 ILS). Patients with simple FSD and stress-exacerbated diseases showed significant cost reductions (P < 0.05), while those with organic disease or difficult FSD did not demonstrate significant changes. Analysis by DCG revealed that baseline diagnostic classification significantly predicted cost reduction. Conclusion: Healthcare utilization and costs were reduced among FSD patients receiving multidisciplinary treatment, with outcomes varying by diagnostic classification. Baseline diagnostic classification reliably predicted treatment cost-effectiveness, underlining the economic value of collaborative care for patients with simple functional disorders and stress-exacerbated diseases. These diagnostic patterns provide healthcare policymakers with selection criteria for multidisciplinary programs and inform the development of tailored interventions.