Influences of Patient Faithfulness and Physician Characteristics on Physicians’ Prescribing Behavior in Outpatient Settings
Date Issued
2012
Date
2012
Author(s)
Sheu, Jong-Yih
Abstract
Abstract
Objectives: Chronic patient visiting a physician with long-term continuity, also called patient faithfulness, is deemed a better healthcare model for outpatient services. It not only builds up trust between patients and physicians but also increases patients’ satisfaction with the quality of care. However, whether patient faithfulness contributes to physician’s prescribing behavior, and if yes, to what extent and in what way, which lacks quantitative data to validate and support. This study aims to investigate how patients’ faithfulness, by taking into account physicians’ characteristics, correlates with physicians’ prescribing behaviors.
Methods: This study basically follows a cross-sectional design, using “non-specific essential hypertension” as the example to explore the above relationships. Patient faithfulness was measured by continuity of visiting a specific doctor from January 2009 to December 2010, a total of 80 physicians and their 27,128 prescription records during the above period of time were included in this study. Physician characteristics were measured by their prescribing practices and socio-demographic factors. Using SAS9.2, the data analysis was carried out by the methods ofχ2 test, F test, and multiple logistic analysis.
Results: Patients who are female and with older age were less likely to visit physicians in a continuous basis, i.e., with lower level of faithfulness. To physicians with greater level of faithfulness, physicians tended to prescribe fewer drugs, give fewer sub-diagnoses, fill longer prescription days, and dispense Chronic Illness Prescription Slip. In general, physicians who were older in age were apt to influence by patients’ faithfulness. On the contrary, physicians holding higher positions were less influenced by patients’ faithfulness. Moreover, patient-physician communication depended more on physicians’ characteristics rather than patients’ faithfulness.
Conclusions: Patient faithfulness leads to a greater control of disease, decrease visits, reduce total prescription items, and also increase prescription with longer period of time. As a result, patient faithfulness enhances the efficiency in NHI resource consumption. Particularly, patients’ faithfulness significantly affected physicians who were older and senior in practices. Notably, however, improved patient-physician communication might not be generated through visiting a physician with long-term continuity. Findings from this study can inform the government in the development of faithful patient policy.
Subjects
Outpatient services
continuity of care
prescribing behavior
physician-patient communication
hypertension care
Type
thesis
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