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Doctor shopping behaviour and its predisposing factors amongst dermatology patients
Nizafaziasyida Fauzee Andylim1, Adawiyah Jamil2, Norazirah Md Nor3.
Doctor shopping increases health economic burden and morbidities. Its prevalence and predisposing factors have to be
identified in order to formulate preventive measures. We aimed to determine the prevalence of doctor shopping, its reasons
and predisposing factors by conducting a cross sectional study of new patients at the Dermatology Clinic, Universiti
Kebangsaan Malaysia Medical Centre (UKMMC). Doctor shopping was defined as having consultation with ≥3 healthcare
providers without a referral for the same illness prior to the patients’ visit to UKMMC. Reasons and contributing factors
were classified as disease, healthcare provider, logistic and cost related. Data was collected by a face to face interview.
Dermatology Life Quality Index (DLQI) questionnaire determined disease impact on the patients. A total of 58 (55.8%)
female and 46 (44.2%) male patients participated. Referral was patient-initiated in 51.9% while 40.4% were doctor
shopping. Age, gender, ethnicity, income, occupation and type of health finance provider were not associated with this
behaviour. About 95% doctor shopped due to disease factors: searching for a cure (95.2%), lack of improvement (88.1%),
worsening disease (50.0%), dissatisfaction with treatment (31.0%), seeking other opinions (26.2%) and exploring
treatment options (26.2%). Impaired DLQI (OR 1.17; 95% CI 1.08,1.38), p 0.04, and disease related factors (OR 6.57; 95%
CI 1.52, 7.72), p 0.041 were significant independent risk factors. Doctor shopping is very common among our patients.
Reasons and predisposing factors are predominantly disease related. Patient education and counselling is important in
management of dermatological diseases to prevent doctor shopping.
Affiliation:
- Hospital Pekan, Malaysia
- Universiti Kebangsaan Malaysia Medical Centre, Malaysia
- Universiti Kebangsaan Malaysia Medical Centre, Malaysia
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