ABSTRACT
Background: Doctor shopping is defined as the practice of patient seeking multiple health care providers without making efforts to coordinate care or informing physicians of the multiple care givers for the same illness or to procure prescription drugs illicitly. This study was planned to explore the doctor shopping behaviour and its determinants among people with chronic diseases in rural Kancheepuram district, Tamil Nadu.Methods: A cross sectional study was conducted among patients of chronic diseases residing in Sembakkam village, Kancheepuram District, Tamil Nadu. Data was collected using a pre-tested semi-structured schedule adopted from Agarwal et al will be used.Results: Prevalence of doctor shopping was found to be 73.7% among the study population which is visiting more than one doctor for the same diagnosis. The main reason given by the participants for consulting more than one doctor was consistence of the symptoms (34%) followed by location of the health facility (15.9%) and non-acceptance of the diagnosis (15.5%).Conclusions: Patient education, good interpersonal communication skills, and health system strengthening measures can increase responsiveness of the community toward the health systems and thereby reduce doctor shopping behaviour.
ABSTRACT
@#Doctor shopping increases health economic burden and morbidities. Its prevalence and predisposing factors have to beidentified in order to formulate preventive measures. We aimed to determine the prevalence of doctor shopping, its reasonsand predisposing factors by conducting a cross sectional study of new patients at the Dermatology Clinic, UniversitiKebangsaan Malaysia Medical Centre (UKMMC). Doctor shopping was defined as having consultation with ≥3 healthcareproviders without a referral for the same illness prior to the patients’ visit to UKMMC. Reasons and contributing factorswere classified as disease, healthcare provider, logistic and cost related. Data was collected by a face to face interview.Dermatology Life Quality Index (DLQI) questionnaire determined disease impact on the patients. A total of 58 (55.8%)female and 46 (44.2%) male patients participated. Referral was patient-initiated in 51.9% while 40.4% were doctorshopping. Age, gender, ethnicity, income, occupation and type of health finance provider were not associated with thisbehaviour. About 95% doctor shopped due to disease factors: searching for a cure (95.2%), lack of improvement (88.1%),worsening disease (50.0%), dissatisfaction with treatment (31.0%), seeking other opinions (26.2%) and exploringtreatment options (26.2%). Impaired DLQI (OR 1.17; 95% CI 1.08,1.38), p 0.04, and disease related factors (OR 6.57; 95%CI 1.52, 7.72), p 0.041 were significant independent risk factors. Doctor shopping is very common among our patients.Reasons and predisposing factors are predominantly disease related. Patient education and counselling is important inmanagement of dermatological diseases to prevent doctor shopping.