Volume 6, Issue 4 (10-2022)                   EBHPME 2022, 6(4): 273-284 | Back to browse issues page


XML Print


Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:

Seyedin H, Afshari M, Isfahani P, Hasanzadeh E, Radinmanesh M, Corani Bahador R. Strategies for Reducing Induced Demand in Hospitals Affiliated with Iran University of Medical Sciences: A Qualitative Study. EBHPME 2022; 6 (4) :273-284
URL: http://jebhpme.ssu.ac.ir/article-1-407-en.html
Social Determinants of Health Research Center, Saveh University of Medical Sciences, Saveh, Iran , rasoul.bahador@gmail.com
Abstract:   (553 Views)
Background: Induced demand is a major challenge for health systems worldwide. It increases costs, especially for patients. The purpose of this study is to identify strategies for reducing induced demand for health care in hospitals affiliated with the Iran University of Medical Sciences (IUMS).
Methods: This was a qualitative study conducted in 2018. The authors conducted in-depth, semi-structured interviews with 20 participants, including IUMS faculty members, physicians, public hospital managers, patients, and researchers with academic and practical experience. Inductive content analysis was used to analyze data. Data analysis was performed in MAXQDA10.
Results: Overall,  the authors extracted 24 subthemes from the interviews and classified them into the health system, insurer, healthcare provider, and healthcare recipient. They are key factors regarding the induced demand for healthcare in the public hospitals under study.
Conclusion: Reducing induced demand for healthcare requires concerted actions by health policymakers and managers at the level of the health system, insurers, healthcare providers, and healthcare recipients. Therefore, policymakers and managers of the health system should take appropriate measures such as the development of guidelines and protocols by different departments, especially the emergency department, classification (primary, secondary, and tertiary care), and referral system. They expand the monitoring role of insurance companies (transforming the payment system into the global diagnosis-related group)  to reduce the induced demand for health. 
Full-Text [PDF 376 kb]   (361 Downloads) |   |   Full-Text (HTML)  (83 Views)  
Type of Study: Original article | Subject: Health Economics
Received: 2022/07/20 | Accepted: 2022/10/26 | Published: 2022/12/31

References
1. Shepherd D, Hodgkin D, & Anthony Y. Analysis of hospital costs: A manual for managers. geneva: World Health Organization; 2002.
2. Maizel S, Passarelli S, Pillari GD. The financial crisis facing America’s hospital industry: Part I. American Bankruptcy Institute Journal. 2007.
3. Seyedin H, Afshari M, Isfahani P, Hasanzadeh E, Radinmanesh M, Bahador RC. The main factors of supplier-induced demand in health care: A qualitative study. Journal of Education and Health Promotion. 2021; 10: 49. [DOI: 10.4103/jehp.jehp_68_20]
4. Abdoli, G. Induce demand: Theory of information asymmetry between patients and doctors. Iranian Journal of Health Economics Research. 2005; 68: 91-114. [In Persian]
5. Pauly MV. Doctors and Their Workshops: Economic Models of Physician Behavior. University of Chicago Press: University of Chicago Press; 2009.
6. Crane ThS. The problem of physician self-referral under the medicare and medicaid anti-kickback statute. The Hanlester Network Case and the Safe Harbor Regulation. Journal of the American Medical Association. 1992; 68(1): 85-91. [DOI: 10.1001/jama.1992.03490010087035]
7. Bickerdyke I, Dolamore R, Monday I, Preston R. Supplier-induced demand for medical services. Canberra: Productivity Commission Staff Working Paper; 2002.
8. Grytten J, Sørensen R. Type of contract and supplier-induced demand for primary physicians in Norway. Journal of Health Economics. 2001; 20(3): 379-93. [DOI: 10.1016/s0167-6296(00)00087-4]
9. Wilensky GR, Rossiter LF. The relative importance of physician-induced demand in the demand for medical care. The Milbank Memorial Fund Quarterly. 1983; 61(2): 252-77. [DOI: 10.2307/3349907]
10. Izumida N, Urushi H, Nakanishi S. An empirical study of the physician-induced demand hypothesis: The cost function approach to medical expenditure of the elderly in Japan. Review of Population and Social Policy. 1999; 8: 11-25.
11. Mahbubi M, Ojaghi S, Ghiasi M, Afkar, A. Supplemental insurance and induced demand in chemical warfare veterans. Iranian Journal of Journal of Military and Veterans’ Health. 2010; 2(4): 18-22. [In Persian]
12. Ansari B, Hosseini SM, Bahadori M. Deter-minants of reduction of induced demand in selected hospitals affiliated with IUMS: A qualitative study from the provider’s perspective. Urmia Nursing and Midwifery Faculty Journal. 2018; 16(6): 389-402. [In Persian]
13. Roemer MI. Bed supply and hospital utilization: A natural experiment. Hospitals. 1961; 35: 36-42.
14. Bajari P, Hong H, Khwaja A. Moral hazard, adverse selection and health expenditures: A semiparametric analysis. National Bureau of Economic Research. 2006.
15. Wanderling D, Groen R, Belak N. Textbook of health economics. Trans. Tofighi S, Ahmadkiadeliri A,Haghparast H. Tehran, Iran: Vajepardazan; 2010. [In Persian]
16. Keyvanara M, Karimi S, Khorasani E, Jafarian Jazi M. Are health institutions involved in health care induced demand? (a qualitative study). Payavard Salamat. 2014; 8(4): 280-93. [In Persian]
17. Braun V, Clarke V. Using thematic analysis in psychology. Qualitative Research in Psychology. 2006; 3(2): 77-101.
18. Riahi, M., Taleghani, Y. M., Salehiniya, H., & Vejdani, M. Induced demand: A challenge on the way of Iran’s health transformation plan. Journal of Pharmaceutical, Biological and Chemical Sciences. 2016; 7(5): 1827-35.
19. Dusansky R, Koç Ç. Implications of the interaction between insurance choice and medical care demand. J Risk Insur. 2010; 77: 129-44. [DOI: 10.1111/j.1539-6975.2009.01335.x]
20. Bogg L, Diwan V, Vora KS, DeCosta A. Impact of alternative maternal demandside financial support programs in India on the Caesarean section rates: Indications of supplier-induced demand. Matern Child Health J. 2016; 20(1): 11–5. [DOI: 10.1007/s10995-015-1810-2]
21. Akhavan Behbahani A, Esmaili I. Supplier-induced demand (SID) for medical services by Iranian physicians (policymaking and controlling). Majlis & Rahbord, 2019; 25(96): 321-41. [In Persian]
22. Dranove D. Health care markets, regulators, and certifiers. Handbook of Health Economics, 2011; 2: 639-90.
23. Ferguson BS, Crawford A. Supplier–induced demand: A disequilibrium test. Applied Economics. 1989; 21(5): 597-610. [DOI: 10.1080/758524893]
24. Seyedin H, Afshari M, Isfahani P, Rakhshan A, Hasanzadeh E, Taherimirghaed M. Main Factors leading to supplier-induced demand in Iran: A comprehensive review. Health Scope. 2020; 9(2): e96366. [DOI: 10.5812/jhealthscope.96366]
25. Hickson GB, Altemeier WA., Perrin JM. Physician reimbursement by salary or fee-for-service: Effect on physician practice behavior in a randomized prospective study. Pediatrics, 1987; 80(3): 344-450.
26. Fabbri D, Monfardini Ch. Demand induction with a discrete distribution of patients. First Edition. Italy, Bologna: University of Bologna; 2001.
27. Abdoli G, Varharami V. The role of asymmetric information in induced demands: A case study of medical services. Iranian Journal of Health Administration. 2011; 14(43): 37-42. [In Persian]
28. Barari M, Afrasiabian Sh, Mohsenpour B, Hajibagheri K, Sheikhesmaili F. Evaluation of appropriate antibiotic administration by general practitioners at the emergency department of a teaching hospital in Sanandaj, Iran. Scientific Journal of Kurdistan University of Medical Sciences. 2018; 23(3): 67-72. [In Persian]
29. Pauly M. Doctors and Their Workshops: Economic Models of Physician Behavior. First Edition. Chicago: University of Chicago Press; 1980.
30. Nyman JA. The economics of moral hazard revisited. Journal of Health Economics. 1999; 18(6): 811-24. [DOI: 10.1016/s0167-6296(99)00015-6]
31. Marcus, D. Coordinating care in an uncoordinated health system: The development and implementation of coordinated care trials in Australia. Department of the Parliamentary Library. 1999.
32. Barigozzi F, Levaggi R. Emotions in physi-cian agency. Health Policy, 2008; 88(1): 1-14. [DOI: 10.1016/j.healthpol.2008.03.005]

Add your comments about this article : Your username or Email:
CAPTCHA

Send email to the article author


Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

© 2024 CC BY-NC 4.0 | Evidence Based Health Policy, Management and Economics

Designed & Developed by : Yektaweb