Study on doctor shopping behavior: insight from patients with upper respiratory tract infection in Taiwan.
OBJECTIVE
Based on the actual medical records of ambulatory care visits, this study analyzed patients' healthcare seeking behavior and doctor shopping behavior (DSB), and investigated the underlying factors and the impact on the depletion of the healthcare resources for health policy makers to build a better health delivery system.


METHODS
Among a cohort comprised of 200,000 patients randomly chosen from the National Health Insurance Research Database of Taiwan in 2004, only the patients seeking ambulatory care visits for upper respiratory tract infection (URI) were analyzed.


RESULTS
Among the 45,951 URI patients, 2875 of them exhibited DSB (prevalence 6.3%). The DSB showed a reverse U-shaped relationship with the patient age (the highest DSB in age 18-34 years). The episodes of the URI had a negative impact on the DSB. The odds ratios of gender and the frequency of consultation versus DSB were 1.10 and 4.72, respectively, and the depletion of days of medication and repeat prescription increased with doctor shopping.


CONCLUSIONS
Health education to raise DSB awareness is necessary, especially for female's age 18-34 years. Implementing a proper referral system with efficient data exchange, setting up control parameters in the IC cards, and strengthening the integrated care plan could reduce the unnecessary waste of the healthcare resources.
Wang
Ming-Jye
MJ
Department of Technology Management, Chung Hua University, Taiwan. jye@hch.gov.tw
Lin
Shu-Ping
SP
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000553:Ambulatory Care / Q000523:psychology* / Q000706:statistics & numerical data; D000704:Analysis of Variance; D002648:Child; D002675:Child, Preschool; D002755:Choice Behavior; D017050:Episode of Care; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D007344:Insurance Claim Reporting / Q000706:statistics & numerical data; D016018:Least-Squares Analysis; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009313:National Health Programs / Q000458:organization & administration; D010342:Patient Acceptance of Health Care / Q000523:psychology* / Q000706:statistics & numerical data; D012017:Referral and Consultation; D012141:Respiratory Tract Infections / Q000517:prevention & control / Q000523:psychology*; D012737:Sex Factors; D013624:Taiwan