Biernikiewicz M1, Germain N2, Toumi M3
1Creativ-Ceutical, Cracow, Poland, 2Creativ Ceutical, Paris, France, 3Aix-Marseille University, Marseille, France
OBJECTIVES: Terms such as overlapping prescriptions, double-doctoring, and doctor-shopping have been coined to describe the practice of consulting multiple physicians for medical advice in one disease episode without referral. This is rooted in reduced patient satisfaction, poor patient-doctor communication, and abuse or misuse of drugs, and may result in increased medical costs and negative health consequences (e.g. iatrogenic harm, polypharmacy, lack of continuity of treatment, burden of unnecessary medical tests). The aim of this literature review was to identify factors associated with doctor-shopping in children’s caregivers. METHODS: A PubMed and grey literature search identified 306 records, of which 8 were selected for analysis. Search terms included doctor- or physician-shopping, double-doctoring, drug-seeking, children, and their combinations. We extracted data on definitions of doctor-shopping, primary and comorbid disease, and patient/caregiver characteristics. RESULTS: Inconsistency in definitions of doctor-shopping was a major source of heterogeneity across the studies analysed. The prevalence of doctor-shopping was 53% in children with fever in Hong Kong, but only 18% at a Canadian emergency department. The proportion of children compared to adults was lower among doctor-shoppers than non-doctor-shoppers, but the prevalence of doctor-shopping peaked in infants below 1 year of age. Doctor-shopping was more frequent among children with acute (e.g. fever, gastroenteritis, urinary tract infection) than chronic (e.g. asthma) disease. Doctor-shopping on behalf of children was associated with comorbid mental disorders in children with ADHD, and also with caregivers who themselves had mental disorders. In these caregivers, their doctor-shopping was extreme. CONCLUSIONS: Little is known about doctor-shopping by children’s caregivers, despite the fact that it is a common behaviour. Further research is needed to cover a wider range of disease and the causes and consequences of doctor-shopping in the context of health care regulations in order to educate caregivers and physicians and limit unnecessary health care costs.
Conference/Value in Health Info
2018-11, ISPOR Europe 2018, Barcelona, Spain
Value in Health, Vol. 21, S3 (October 2018)
Cost/Cost of Illness/Resource Use Studies