Doctor shopping behavior for zolpidem among insomnia patients in Taiwan: A nationwide population-based study

Tzu Hsuan Lu, Yen Ying Lee, Hsin Chien Lee, You Meei Lin

研究成果: 雜誌貢獻文章

6 引文 (Scopus)

摘要

Objectives: Although zolpidem is listed as a controlled drug in Taiwan, patients' behavior has not been restricted and has led to the problem of doctor shopping behavior (DSB), leading to overutilization of medical resources and excess spending. The National Health Insurance Administration in Taiwan has instituted a new policy to regulate physicians' prescribing behavior and decrease DSB. This retrospective study aimed to analyze the DSB for zolpidem by insomnia patients and assess related factors. Design and Participants: Data were extracted from the Longitudinal Health Insurance Database in Taiwan. Individuals with a diagnosis of insomnia who received more than one prescription of zolpidem in 2008 were followed for 24 mo. Doctor shopping was defined as 2 prescriptions by different doctors within 1 day overlapping in the duration of therapy. The percentage of zolpidem obtained through doctor shopping was used as an indicator of the DSB of each patient. Results: Among the 6,947 insomnia patients who were prescribed zolpidem, 1,652 exhibited DSB (23.78%). The average dose of zolpidem dispensed for each patient during 24 mo was 244.21 daily defined doses. The doctor shopping indicator (DSI) was 0.20 (standard deviation, 0.23) among patients with DSB. Younger age, chronic diseases, high number of diseases, higher premium status, high socioeconomic status, and fewer people served per practicing physicians were all factors significantly related to doctor shopping behavior. Conclusion: Doctor shopping for zolpidem appears to be an important issue in Taiwan. Implementing a proper referral system with efficient data exchange by physician or pharmacist-led medication reconciliation process might reduce DSB.
原文英語
頁(從 - 到)1039-1044
頁數6
期刊Sleep
38
發行號7
DOIs
出版狀態已發佈 - 七月 1 2015

指紋

Sleep Initiation and Maintenance Disorders
Taiwan
Population
Physicians
Prescriptions
Medication Reconciliation
zolpidem
National Health Programs
Health Insurance
Pharmacists
Social Class
Chronic Disease
Referral and Consultation
Retrospective Studies
Databases

ASJC Scopus subject areas

  • Physiology (medical)
  • Clinical Neurology

引用此文

Doctor shopping behavior for zolpidem among insomnia patients in Taiwan : A nationwide population-based study. / Lu, Tzu Hsuan; Lee, Yen Ying; Lee, Hsin Chien; Lin, You Meei.

於: Sleep, 卷 38, 編號 7, 01.07.2015, p. 1039-1044.

研究成果: 雜誌貢獻文章

Lu, Tzu Hsuan ; Lee, Yen Ying ; Lee, Hsin Chien ; Lin, You Meei. / Doctor shopping behavior for zolpidem among insomnia patients in Taiwan : A nationwide population-based study. 於: Sleep. 2015 ; 卷 38, 編號 7. 頁 1039-1044.
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abstract = "Objectives: Although zolpidem is listed as a controlled drug in Taiwan, patients' behavior has not been restricted and has led to the problem of doctor shopping behavior (DSB), leading to overutilization of medical resources and excess spending. The National Health Insurance Administration in Taiwan has instituted a new policy to regulate physicians' prescribing behavior and decrease DSB. This retrospective study aimed to analyze the DSB for zolpidem by insomnia patients and assess related factors. Design and Participants: Data were extracted from the Longitudinal Health Insurance Database in Taiwan. Individuals with a diagnosis of insomnia who received more than one prescription of zolpidem in 2008 were followed for 24 mo. Doctor shopping was defined as 2 prescriptions by different doctors within 1 day overlapping in the duration of therapy. The percentage of zolpidem obtained through doctor shopping was used as an indicator of the DSB of each patient. Results: Among the 6,947 insomnia patients who were prescribed zolpidem, 1,652 exhibited DSB (23.78{\%}). The average dose of zolpidem dispensed for each patient during 24 mo was 244.21 daily defined doses. The doctor shopping indicator (DSI) was 0.20 (standard deviation, 0.23) among patients with DSB. Younger age, chronic diseases, high number of diseases, higher premium status, high socioeconomic status, and fewer people served per practicing physicians were all factors significantly related to doctor shopping behavior. Conclusion: Doctor shopping for zolpidem appears to be an important issue in Taiwan. Implementing a proper referral system with efficient data exchange by physician or pharmacist-led medication reconciliation process might reduce DSB.",
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