Doctor-Shopping Behaviors among Traditional Chinese Medicine Users in Taiwan.
Doctor-shopping has caused an increase in medical expense, potential to receive duplicate medications, and suffer adverse drug reactions. We carried out a population-based retrospective study aimed at examining the user patterns of traditional Chinese medicine (TCM) ambulatory care in Taiwan. We retrieved complete TCM ambulatory visit datasets for the year 2007 from the National Health Insurance database in Taiwan. We defined the patients whose distribution of TCM physician numbers scored more than 97.5 percent (more than, or equal to, five TCM physicians) within one year as TCM doctor-shoppers. In total, 6,596,814 subjects (28.9%) paid TCM visits during that year. All 177,728 subjects (2.69%) who visited more than five (including) TCM physicians were classified as TCM shoppers. The most prevalent diagnostic grouping was upper respiratory infections (44.7%) and sprains and strains (44.0%). Men had a lower odds ratio (OR) among TCM shoppers than women (OR = 0.94, 95% confidence interval (CI) = 0.93-0.96). Younger people were less likely to be TCM shoppers than other people were. The ORs of TCM shoppers were higher among veterans and low-income patients (OR = 1.29 (1.23-1.35), and 1.33 (1.27-1.41)). In conclusion, health education on the potential of drug interactions and iatrogenic health risks incurred from doctor-shopping should be addressed to those high-risk patients.
Department of Family Medicine, Taipei Veterans General Hospital, No. 201, Sec. 2, Shi-Pai Road, Taipei 112, Taiwan. minghwai@gmail.com.|School of Medicine, National Yang-Ming University, No. 155, Sec. 2, Linong Street, Taipei 112, Taiwan. minghwai@gmail.com.
Ming-Hwai
MH
Lin
Department of Family Medicine, Taipei Veterans General Hospital, No. 201, Sec. 2, Shi-Pai Road, Taipei 112, Taiwan. htstar@gmail.com.|School of Medicine, National Yang-Ming University, No. 155, Sec. 2, Linong Street, Taipei 112, Taiwan. htstar@gmail.com.
Hsiao-Ting
HT
Chang
School of Medicine, National Yang-Ming University, No. 155, Sec. 2, Linong Street, Taipei 112, Taiwan. cytu1965@gmail.com.|Department of Family Medicine, Taipei Veterans General Hospital, Taoyuan branch, No. 100, Sec. 3, Cheng-Kung Road, Tao-Yuan 330, Taiwan. cytu1965@gmail.com.
Chun-Yi
CY
Tu
Department of Family Medicine, Taipei Veterans General Hospital, No. 201, Sec. 2, Shi-Pai Road, Taipei 112, Taiwan. tjchen@vghtpe.gov.tw.|School of Medicine, National Yang-Ming University, No. 155, Sec. 2, Linong Street, Taipei 112, Taiwan. tjchen@vghtpe.gov.tw.
Tzeng-Ji
TJ
Chen
Department of Family Medicine, Taipei Veterans General Hospital, No. 201, Sec. 2, Shi-Pai Road, Taipei 112, Taiwan. sjhwang@vghtpe.gov.tw.|School of Medicine, National Yang-Ming University, No. 155, Sec. 2, Linong Street, Taipei 112, Taiwan. sjhwang@vghtpe.gov.tw.
Shinn-Jang
SJ
Hwang
D000293:Adolescent; D000328:Adult; D000368:Aged; D000553:Ambulatory Care / Q000706:statistics & numerical data*; D002648:Child; D002675:Child, Preschool; D016208:Databases, Factual; D004347:Drug Interactions; D005260:Female; D006266:Health Education; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008516:Medicine, Chinese Traditional / Q000706:statistics & numerical data*; D008875:Middle Aged; D016017:Odds Ratio; D010820:Physicians / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012959:Socioeconomic Factors; D013624:Taiwan; D055815:Young Adult
complementary and alternative medicine; doctor shopping; national health insurance; traditional Chinese medicine; utilization