The association between continuity of care and Doctor-shopping behavior
Date Issued
2011
Date
2011
Author(s)
Wu, Hsin-Yu
Abstract
The purpose of this study was to understand the association between continuity of care (COC) and the doctor-shopping behavior (DSB) in Taiwan and if the COC indicies could be use as a predicator of the DSH in the future. This study’s data was using the 2005 National Health Insurance Registry for Beneficiaries Claims Data files, the medical service utilization data of 200,000 persons. Only collected the people who have been visited doctors because of URI (upper respiratory tract infection) and AGE (acute gastroenteritis), and those people should visited doctors for more than 3 times in whole year. So that there are 129,076 people involve because of URI and 53,029 people involved because of AGE.
We found out people who have DSB and hospital-shopping behavior (HSB) because of URI were 53759 and 44087 people, respectivel, and the prevalence of DSB and HSB were 41.65% and 34.16%, respectively. About the AGE part, who have DSB and HSB were 7412 and 4780 people, respectively, and the prevalence of DSB and HSB were 13.98% and 9.01%, respectively. The average times of DSB and HSB were 3.38 and 2.53 times in URI group and 1.98 and 1.81 times in AGE group, respectively.
Negative binominal regressions were performed to examine the effect of three different COC indices on the numbers of DSB and HSB, logistic regressions were used to exam the COC indices with do or do not have the DSB and HSB.
The data suggest that lower COC was associated with increased risk of DSB and HSB. Compare with the high COC groups, subjects in the low and medieum COC groups had 2.10-3.66 times and 1.45-2.19 times of DSB, respectively, as well as 2.02-3.42 times and 1.37-2.05 times of HSB, respectively. Compare with the high COC groups, subjects in the low and medieum COC groups had 87%-217% and 55%-141% more DSB, respectively, as well as 101%-199% and 58%-122% more HSB, respectively.
While using the 2006’s DSB and HSB as an dependent variable, compare with the high COC groups, subjects in the low and medieum COC groups had 1.43-1.99 times and 1.29-1.59 times of DSB, respectively, as well as 1.38-1.89 times and 1.23-1.50 times of HSB, respectively. Compare with the high COC groups, subjects in the low and medieum COC groups had 35%-92% and 31%-55% more DSB, respectively, as well as 32%-89% and 28%-51% more HSB, respectively.
This study indicates that lower COC indices were associated with increased DSB and HSB, also with higher risk of DSB and HSB. The data even shows the same results in 2006’s DSB and HSB, no matteer in the URI group or AGE group. This study suggests that improving the COC might decrease the prevalence of DSB an HSB.
Subjects
URI
AGE
doctor-shopping behavior
hospital-shopping behavior
continuity of care
Type
thesis
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