Feng Xiaoqi
Centre for Health Research, School of Medicine, University of Western Sydney, Australia.
Obesity (Silver Spring). 2013 Nov;21(11):2225-30. doi: 10.1002/oby.20586. Epub 2013 Sep 5.
A recent study has suggested that overweight and obese people are more likely to consult a range of physicians (doctor shopping). The consistency of this finding with multiple measures of doctor shopping and controls for socioeconomic circumstances was interrogated.
Ninety-nine thousand four hundred seven Australians aged 45 and over who had sought primary healthcare at least five times within 6 months of a survey (2006-2008). (i) The count of different physicians consulted; a binary indicator of (ii) >= three different physicians; (iii) >= five different physicians; and iv) a measure that took into account multiple consultations with the same physician were investigated. Weight status was measured using Body Mass Index (BMI) based on self-reported height and weight. Controls included socioeconomic circumstances, demographics, health, and neighborhood factors.
In comparison to people with "normal" BMI, the likelihood of doctor shopping was lower among overweight (Incidence Rate Ratio: 0.97, 95%CI: 0.96, 0.98) and obese people (0.95: 0.93, 0.96). This negative correlation between doctor shopping behavior and weight status was consistent after full adjustment and across different outcome measures.
In contrast with recent evidence from the US, overweight and obese Australians are less prone to doctor shopping behavior than their peers with "normal" BMI.
最近一项研究表明,超重和肥胖人群更有可能咨询一系列医生(反复就医)。本研究探讨了这一发现与反复就医的多种衡量指标以及社会经济状况控制因素之间的一致性。
对99407名年龄在45岁及以上、在调查(2006 - 2008年)前6个月内至少寻求过5次初级医疗保健服务的澳大利亚人进行研究。(i)统计咨询过的不同医生数量;(ii)咨询过 >= 3名不同医生的二元指标;(iii)咨询过 >= 5名不同医生的二元指标;以及(iv)一项考虑了与同一名医生多次咨询情况的衡量指标。体重状况根据自我报告的身高和体重,使用体重指数(BMI)进行测量。控制因素包括社会经济状况、人口统计学特征、健康状况和邻里因素。
与BMI“正常”的人群相比,超重人群(发病率比:0.97,95%置信区间:0.96,0.98)和肥胖人群(0.95:0.93,0.96)反复就医的可能性较低。在进行全面调整后以及不同的结果衡量指标中,反复就医行为与体重状况之间的这种负相关关系是一致的。
与美国最近的证据相反,超重和肥胖的澳大利亚人比BMI“正常”的同龄人更不容易出现反复就医行为。