Doctor shopping by overweight and obese patients is associated with increased healthcare utilization. (13th May 2013)

• Record Type: Journal Article
• Authors: Gudzune, Kimberly A.; Bleich, Sara N.; Richards, Thomas M.; Weiner, Jonathan P.; Hodges, Krista; Clark, Jeanne M.
• Is Part Of: Obesity. Volume 21:Number 7(2013:Jul.)
• Page Start: 1328
• Page End: 1334
• Publication Date: 2013-05-13
• Subjects: Obesity -- Periodicals; 616.398005
• DOI: 10.1002/oby.20189
• Languages: English
• ISSNs: 1930-7381

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="oby20189-sec-0001" sec-type="section"> <title>Objective</title> <p>Negative interactions with healthcare providers may lead patients to switch physicians or "doctor shop." We hypothesized that overweight and obese patients would be more likely to doctor shop, and as a result, have increased rates of emergency department (ED) visits and hospitalizations as compared to normal weight nonshoppers.</p> </sec> <sec id="oby20189-sec-0002" sec-type="section"> <title>Design and Methods</title> <p>We combined claims data from a health plan in one state with information from beneficiaries' health risk assessments. The primary outcome was "doctor shopping, " which we defined as having outpatient claims with ≥5 different primary care physicians (PCPs) during a 24‐month period. The independent variable was standard NIH categories of weight by BMI. We performed multivariate logistic regression to evaluate the association between weight categories and doctor shopping. We conducted multivariate zero‐inflated negative binominal regression to evaluate the association between weight‐doctor shopping categories with counts of ED visits and hospitalizations.</p> </sec> <sec id="oby20189-sec-0003" sec-type="section"> <title>Results</title> <p>Of the 20, 726 beneficiaries, the mean BMI was 26.3 kg m<sup>−2</sup> (SD 5.1), mean age was 44.4 years (SD 11.1) and 53% were female. As compared to normal weight beneficiaries, overweight beneficiaries had 23% greater adjusted odds of doctor shopping (OR 1.23, 95%CI 1.04‐1.46) and obese beneficiaries had 52% greater adjusted odds of doctor shopping (OR 1.52, 95%CI 1.26‐1.82). As compared to normal weight non‐shoppers, overweight and obese shoppers had higher rates of ED visits (IRR 1.85, 95%CI 1.37‐2.45; IRR 1.83, 95%CI 1.34‐2.50, respectively), which persisted during within weight group comparisons (Overweight IRR 1.50, 95%CI 1.10‐2.03; Obese IRR 1.54, 95%CI 1.12‐2.11).</p> </sec> <sec id="oby20189-sec-0004" sec-type="section"> <title>Conclusion</title> <p>Frequently changing PCPs may impair continuity and result in increased healthcare utilization.</p> </sec> </abstract>