title: Consultation behaviour of doctor-shopping patients and factors that reduce shopping.
abstract: OBJECTIVE
  To investigate the subsequent behaviour of doctor-shopping patients (defined as those attending multiple hospitals for the same complaint) who consulted our department and factors related to cessation of doctor shopping.
  
  
  METHODS
  Patients who presented without referral to the Department of General Medicine at Chiba University Hospital in Japan (our department) completed a questionnaire at their first visit. A follow-up questionnaire was also sent to them in order to assess doctor shopping after 3 months. Then items in the questionnaires were investigated for significant differences between patients who continued or stopped doctor shopping. Logistic regression analysis was performed with items showing a significant difference between patients who stopped doctor shopping and those who continued it, in order to identify independent determinants of the cessation of shopping.
  
  
  RESULTS
  A total of 978 patients who presented spontaneously to our department consented to this study, and 929 patients (95.0%) completed questionnaires correctly. Among them, 203 patients (21.9%) were identified as doctor shoppers. The follow-up survey was completed correctly by 138 patients (68.0%). Among them, 25 patients (18.1%) were found to have continued doctor shopping, which was a significantly lower rate than before (P < 0.001). Logistic regression analysis selected the following factors as independent determinants of the cessation of doctor shopping: 'confirmation of the diagnosis' (odds ratio: 8.12, 95% confidence interval: 1.46-45.26), and 'satisfaction with consultation' (odds ratio: 2.07, 95% confidence interval: 1.42-3.01).
  
  
  CONCLUSIONS
  Doctor shopping decreased significantly after patients consulted our department, with 'confirmation of the diagnosis' and 'satisfaction with consultation' being identified as contributing factors.
authors.affiliation: Department of General Medicine, Chiba University Hospital, Chiba, Japan. y-ohira@kc4.so-net.ne.jp
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Ohira
authors.forename: Masatomi
authors.initials: M
authors.lastname: Ikusaka
authors.forename: Kazutaka
authors.initials: K
authors.lastname: Noda
authors.forename: Tomoko
authors.initials: T
authors.lastname: Tsukamoto
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Takada
authors.forename: Masahito
authors.initials: M
authors.lastname: Miyahara
authors.forename: Hiraku
authors.initials: H
authors.lastname: Funakoshi
authors.forename: Ayako
authors.initials: A
authors.lastname: Basugi
authors.forename: Katsunori
authors.initials: K
authors.lastname: Keira
authors.forename: Takanori
authors.initials: T
authors.lastname: Uehara
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016009:Chi-Square Distribution; D002755:Choice Behavior; D005260:Female; D015438:Health Behavior; D006801:Humans; D007564:Japan; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D012017:Referral and Consultation / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires