Department of General Medicine, Chiba University Hospital, Chiba, Japan.
J Eval Clin Pract. 2012 Apr;18(2):433-40. doi: 10.1111/j.1365-2753.2010.01605.x. Epub 2010 Nov 22.
RATIONALE, AIMS AND OBJECTIVES: To investigate the subsequent behaviour of doctor-shopping patients (defined as those attending multiple hospitals for the same complaint) who consulted our department and factors related to cessation of doctor shopping.
Patients who presented without referral to the Department of General Medicine at Chiba University Hospital in Japan (our department) completed a questionnaire at their first visit. A follow-up questionnaire was also sent to them in order to assess doctor shopping after 3 months. Then items in the questionnaires were investigated for significant differences between patients who continued or stopped doctor shopping. Logistic regression analysis was performed with items showing a significant difference between patients who stopped doctor shopping and those who continued it, in order to identify independent determinants of the cessation of shopping.
A total of 978 patients who presented spontaneously to our department consented to this study, and 929 patients (95.0%) completed questionnaires correctly. Among them, 203 patients (21.9%) were identified as doctor shoppers. The follow-up survey was completed correctly by 138 patients (68.0%). Among them, 25 patients (18.1%) were found to have continued doctor shopping, which was a significantly lower rate than before (P < 0.001). Logistic regression analysis selected the following factors as independent determinants of the cessation of doctor shopping: 'confirmation of the diagnosis' (odds ratio: 8.12, 95% confidence interval: 1.46-45.26), and 'satisfaction with consultation' (odds ratio: 2.07, 95% confidence interval: 1.42-3.01).
Doctor shopping decreased significantly after patients consulted our department, with 'confirmation of the diagnosis' and 'satisfaction with consultation' being identified as contributing factors.
背景、目的和目标：调查在日本千叶大学医院综合内科就诊（定义为因同一症状多次就诊于不同医院的患者）的“购医”患者的后续行为以及与停止“购医”相关的因素。
在日本千叶大学医院综合内科就诊的患者（我院）在首次就诊时填写问卷。为评估 3 个月后的“购医”行为，我们还向他们发送了后续问卷。然后对问卷中的项目进行调查，以评估停止“购医”和继续“购医”患者之间的差异。对停止“购医”和继续“购医”患者之间存在显著差异的项目进行逻辑回归分析，以确定停止“购医”的独立决定因素。
共有 978 名自发到我院就诊的患者同意参加本研究，其中 929 名患者（95.0%）正确填写了问卷。在这些患者中，203 名（21.9%）被确定为“购医”患者。138 名（68.0%）患者正确完成了随访调查，其中 25 名（18.1%）患者仍在继续“购医”，这一比例明显低于之前（P < 0.001）。逻辑回归分析选择以下因素作为停止“购医”的独立决定因素：“明确诊断”（比值比：8.12，95%置信区间：1.46-45.26）和“对咨询的满意度”（比值比：2.07，95%置信区间：1.42-3.01）。
在我院就诊后，“购医”行为显著减少，“明确诊断”和“对咨询的满意度”是导致这一结果的因素。
