title: Healthcare Service Utilization for Practicing Physicians: A Population-Based Study.
abstract: BACKGROUND
  Physicians are considered to be the most informed consumers in the use of medical services since they have more information about diseases or medical technology. However, although plenty of researchers have suggested that different medical seeking behavior exists among physicians, very few empirical studies have been conducted to investigate differences in medical utilization between physicians and the general population.
  
  
  OBJECTIVE
  We explored differences in the utilization of healthcare services between physicians and the general population using a population-based dataset.
  
  
  METHODS
  A cross-sectional study.
  
  
  METHODS
  Data for this study were sourced from the Taiwan Longitudinal Health Insurance Database 2000. We included 1426 physicians and 1426 sex- and age-matched comparison subjects.
  
  
  METHODS
  We used Wilcoxon-Mann-Whitney tests to explore differences in variables of healthcare resource utilization between physicians and comparison subjects. We further used Kruskal-Wallis tests to examine differences in variables of healthcare resource utilization between physician practice location and comparison subjects.
  
  
  RESULTS
  We found that physicians had significantly fewer outpatient visits (13.2 vs. 15.7, p<0.001) and significantly lower outpatient costs (US$477 vs. US$680, p<0.001) than comparison subjects. Furthermore, physicians had lower total health service costs than comparison subjects (US$643 vs. US$1066, p<0.001). This indicates that the mean total health service costs in the year 2010 was 1.66-fold greater for comparison subjects than for physicians. We also found that there were significant differences in the mean number of outpatient services (p<0.001), outpatient costs (p = 0.001), inpatients costs (p = 0.018), and total costs (p = 0.001) among office-based physicians, hospital-based physicians, and comparison subjects. Specifically, Scheffe contrast tests showed that office-based physicians had significantly more outpatient visits (19.3 vs.10.7, p<0.001) and significantly higher outpatient costs (US$656 vs. US$402, p<0.001) than hospital-based physicians.
  
  
  CONCLUSIONS
  Physicians had less healthcare utilization than comparison subjects. Furthermore, hospital-based physicians had higher inpatient costs and less outpatient services and costs than office-based physicians.
authors.affiliation: Graduate Institute of Medical Science, National Defense Medical Center, Taipei, Taiwan.|School of Public Health, National Defense Medical Center, Taipei, Taiwan.|Sleep Research Center, Taipei Medical University Hospital, Taipei, Taiwan.
authors.forename: Yu-Lung
authors.initials: YL
authors.lastname: Chiu
authors.affiliation: School of Public Health, National Defense Medical Center, Taipei, Taiwan.
authors.forename: Senyong
authors.initials: S
authors.lastname: Kao
authors.affiliation: Sleep Research Center, Taipei Medical University Hospital, Taipei, Taiwan.|School of Health Care Administration, Taipei Medical University, Taipei, Taiwan.
authors.forename: Herng-Ching
authors.initials: HC
authors.lastname: Lin
authors.affiliation: School of Health Care Administration, Taipei Medical University, Taipei, Taiwan.|Division of Gastroenterology, Department of Internal Medicine, Cathay General Hospital, Taipei, Taiwan.
authors.forename: Ming-Chieh
authors.initials: MC
authors.lastname: Tsai
authors.affiliation: Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Cha-Ze
authors.initials: CZ
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D000553:Ambulatory Care / Q000191:economics / Q000706:statistics & numerical data; D003153:Community Health Services / Q000191:economics / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D016208:Databases, Factual; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D007722:Health Knowledge, Attitudes, Practice; D006760:Hospitalization / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D007348:Insurance, Health / Q000191:economics; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000523:psychology / Q000706:statistics & numerical data*; D010820:Physicians / Q000191:economics / Q000523:psychology*; D013624:Taiwan