Department of Paediatrics, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong.
Hong Kong Med J. 2013 Feb;19(1):6-12.
To estimate prevalence and assess factors associated with doctor shopping among caregivers of children acutely admitted to a hospital in Hong Kong, and examine the reasons for such behaviour and caregivers' awareness of its possible dangers.
Cross-sectional study with face-to-face surveys.
A paediatric unit in a teaching hospital in Hong Kong.
Caregivers of children admitted to acute paediatric wards between April and July 2011. MAIN OUTCOME MEASURES; Socio-demographic characteristics of the interviewee, personal history and clinical data of the patient, presence of doctor shopping (consulting more than one doctor for medical advice without referral) for each episode, the reasons behind such behaviour, and awareness of potential dangers. Data retrieved were analysed to estimate the prevalence and logistic regression was used to assess factors associated with doctor shopping.
In all, 649 such patients were admitted into hospital during the study period, of which 336 were recruited, with about a half being absent or given home leave. Thirty-four patients were excluded due to absent caregivers or refusal, and 302 were included in the study. More than half (79.5%) were female and the caregivers' monthly household incomes were between HK$10 001 and HK$15 000 (21.2%), similar to the median household income in Hong Kong. The prevalence of doctor shopping was 53%. The only significant clinical parameter associated with doctor shopping was presence of fever (odds ratio=2.4; 95% confidence interval, 1.4-3.9). Persistence of symptoms was the commonest reason given by interviewees for doctor shopping, and the majority (75.5%) were unaware of the possible dangers of this behaviour.
Doctor shopping is highly prevalent among caregivers of children with acute paediatric conditions. Most caregivers do not know the potential complications of this behaviour. Further measures should be taken to educate subjects on the associated dangers of this behaviour and the natural course of acute illnesses with fever.
评估香港某医院急性住院患儿照顾者的医生寻诊率，并分析其相关因素，探讨照顾者医生寻诊的原因及其对此行为潜在危险的认知。
横断面研究，面对面问卷调查。
香港一家教学医院的儿科病房。
2011 年 4 月至 7 月期间入住院儿科病房的患儿照顾者。
受访者的社会人口学特征、患者的个人病史和临床资料、每次寻诊的医生数量、寻诊原因，以及对潜在危险的认知。分析所获数据以评估医生寻诊率，并采用逻辑回归分析评估与医生寻诊相关的因素。
研究期间共有 649 名患儿住院，其中 336 名被纳入研究，约一半患儿的照顾者缺勤或被批准离院。由于照顾者不在或拒绝接受调查，34 名患儿被排除，最终有 302 名患儿纳入研究。照顾者中女性占 59.5%，月家庭收入在 1000115000 港元（中位数为 12500 港元）之间，与香港家庭收入中位数相近。医生寻诊率为 53%。与医生寻诊相关的唯一显著临床参数为发热（比值比=2.4；95%可信区间为 1.43.9）。症状持续是照顾者医生寻诊的最常见原因，其中 75.5%的照顾者不知道这种行为的潜在危险。
急性儿科疾病患儿照顾者的医生寻诊率很高，大多数照顾者不知道这种行为的潜在并发症。应进一步采取措施，对照顾者进行有关该行为相关危险和发热性急性疾病自然病程的教育。
