Study on Doctor-Shopping Behavior among Patients and Methods to Reduce This Problem

Project: Research

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With an aging population, health care resources are becoming increasingly limited. Governments in many countries are faced with steeply rising health care costs, and patients are experiencing excessively long waiting times. Doctor-shopping behavior among patients, defined as visiting multiple medical practitioners during a single illness episode without referrals, makes the situation even worse. Doctor-shopping behavior is very common in many health care systems. For example, in Hong Kong, the rate of doctor shopping was reported to be as high as 40% in public outpatient clinics (Lo et al., 1994). Repeated consultations and examinations cause unnecessary costs and congestion for health care systems. It is widely believed that cognitive dissonance on certain illness between patients and medical practitioners is the main reason for doctor-shopping behavior by patients. In the proposed project, we aim to comprehensively study doctor shopping with regard to patients and medical practitioners. We plan to capture the doctor-shopping behavior of patients by applying Bayes' rule and derive the numbers of doctor-shopping times for different types of patients. The proposed model can capture the dynamic updating process of patients' illness perceptions after obtaining multiple diagnoses from different doctors. We will also investigate how patients' doctor-shopping times change according to the patient type, which will be classified according to their prior illness perception and diagnostic quality, which will be captured by type I and type II errors in the diagnostic process. With regard to medical practitioners, we will investigate the appropriate length of time they should spend on a diagnosis. We assume the following: the shorter time a medical practitioner spends with patients, the more ambiguity on illness perception and the greater the doctor-shopping rate. A long queue might push doctors to work faster by reducing the consultation time with patients, which can increase the patients' doctor­shopping rate, and, in turn, increase the workload on the health care system. The proposed project aims to study the optimal decision making by doctors regarding service times under both revenue-maximization and welfare-maximization objectives and conduct a comparison between the optimal decisions under these two objectives. Other than the aforementioned objectives, the proposed project also aims to explore the role of pricing in reducing the doctor-shopping rate, as price not only affects doctor­shopping costs but also changes the financial incentives for medical practitioners to adjust their service rates. The outcome of this research can shed light on doctor­shopping behavior and methods to reduce the problem. 


Project number9043108
Grant typeGRF
Effective start/end date1/01/1822/12/21