Doctor-Shopping in Hong Kong: Implications for Quality of Care

Abstract

Doctor-shopping is defined as the changing of doctors without professional referral in the same illness episode. Two surveys on samples of patients attending Government Out-Patient Departments (GOPDs) in Hong Kong in 1989 (n = 869) and 1990 (n = 901) estimated the prevalence of shopping at nearly 40%, the main reason being a persistence of symptoms. Doctor-shoppers were likely to be younger with higher expectations of health care and who expressed dissatisfaction about aspects of the present service. In Hong Kong, patients perceive western medicine to be more effective and have high expectations of the effects of western drugs, in particular, in their administration by injection. Patients should be warned about iatrogenic health risks incurred from doctor-shopping; health education programmes are needed to modify unrealistic views about quality care. Health care providers in a mixed care system should promote greater continuity of care between doctors and both the public and private sectors, and identify and resolve problems which may be responsible for discontinuity of care.

Measuring quality of life of Chinese cancer patients

“…For instance, the two Doc subscale items do not seem to address the same dimension. Attitudes toward the doctor-patient relationship in Hong Kong may differ from those in the U.S., 15,16 and doctors are usually less accessible. This is generally accepted and does not necessarily affect confidence in one's doctor.…”

The mental health of doctor-shoppers: Experience from a patient-led fee-for-service primary care setting

“…DS patients have been found to be more chronically ill and have higher GHQ scores (Sato et al, 1995). Factors related to the health care system include convenience, waiting time, fees and doctor's reputation (Billinghurst & Whitfield, 1993;Bronstein et al, 2000;Leung et al, 2006;Lo et al, 1994;Yeung et al, 2004). Studies on DS in France have only focused on the prescription of drugs, namely High Dosage Buprenorphine (Feroni et al, 2005;Pradel et al, 2009), DS acting as a mechanism for obtaining multiple prescriptions and accounting for 15% to 20% of all prescriptions (Pradel et al, 2009).…”

Translation and validation of the Functional Assessment of Cancer Therapy–Bone Marrow Transplant (FACT-BMT) Version 4 quality of life instrument into traditional Chinese

“…Step Task Personnel Requirements/Purposes Pretesting with patients Native speaking patients (15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30) with relevant Assess comprehension and acceptability diagnosis between the FACT-G and the WHOQOL-BREF (HK) were found to be low, and the team eventually had to acknowledge that the evidence concerning convergent validity was weak. 16 The original FACT-G English Version 3 was updated to Version 4 in 1997 due to the translation and validation of the FACT-G into more than 20 languages.…”

“…18 One noticeable change was that Version 4 excluded the two 'Relationship with Doctor' items from the FACT-G. 15 This is particularly suitable in Hong Kong, where the doctor-patient relationship is different from that in the US. 19 Other changes in Version 4 include item wording, item numbering and scoring. 15 Because of these changes, a new traditional Chinese translation following well-established FACIT translation methodology was required; hence, our development of the TCHI FACT BMT Version 4.…”