Competition-driven physician-induced demand

Ikegami, Kei; Wakamori, Naoki

doi:10.1016/j.jhealeco.2021.102488

Cited by 10 publications

(11 citation statements)

References 21 publications

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“…Marriage may increase healthcare needs through the spouse’s care and his (or her) encouragement to visit a physician [ 45 , 46 ]. One reason why people residing in the Seoul metropolitan area are less likely to experience healthcare needs than those living outside this area may be that these residents have continued to meet sufficient healthcare needs because healthcare providers are highly concentrated in this area [ 47 , 48 ]. Moreover, people may be able to manage their health conditions better with more information about health in the Seoul metropolitan area, thereby not leading to healthcare needs.…”

Section: Discussionmentioning

confidence: 99%

“…Particularly, the finding that residents in the Seoul metropolitan area are more likely to experience “financial difficulty” than non-residents may be partly because healthcare providers are highly concentrated in the Seoul metropolitan area and under a high degree of competition. To reach their target income, healthcare providers may induce people to visit them more frequently, probably by offering high-quality and high-price healthcare services not covered by the NHI program [ 9 , 47 , 48 ].…”

Section: Discussionmentioning

confidence: 99%

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Changes in Barriers That Cause Unmet Healthcare Needs in the Life Cycle of Adulthood and Their Policy Implications: A Need-Selection Model Analysis of the Korea Health Panel Survey Data

Chung

2022

Healthcare

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Using 68,930 observations selected from 16,535 adults in the Korea Health Panel Survey (2014–2018), this study explored healthcare barriers that prevent people from meeting their healthcare needs most severely during adulthood, and the characteristics that are highly associated with the barrier. This study derived two outcome variables: a dichotomous outcome variable on whether an individual has experienced healthcare needs, and a quadchotomous outcome variable on how an individual’s healthcare needs ended. An analysis was conducted using a multivariable panel multinomial probit model with sample selection. The results showed that the main cause of unmet healthcare needs was not financial difficulties but non-financial barriers, which were time constraints up to a certain age and the lack of caring and support after that age. People with functional limitations were at a high risk of experiencing unmet healthcare needs due to a lack of caring and support. To reduce unmet healthcare needs in South Korea, the government should focus on lowering non-financial barriers to healthcare, including time constraints and lack of caring and support. It seems urgent to strengthen the foundation of “primary care”, which is exceptionally scarce now, and to expand it to “community-based integrated care” and “people-centered care”.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Changes in Barriers That Cause Unmet Healthcare Needs in the Life Cycle of Adulthood and Their Policy Implications: A Need-Selection Model Analysis of the Korea Health Panel Survey Data

Chung

2022

Healthcare

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“…However, the current study shows that both men and women living in the Seoul metropolitan area were exposed to a greater risk of a financial barrier after adjusting for other characteristics than those living outside this area. This finding may be related to the fact that healthcare providers are highly concentrated in the Seoul metropolitan area, which may intensify competition-driven physician-induced demand (32,33). It may be postulated that that these healthcare providers offer highquality and high-price healthcare services not covered by the NHI programme or that they are likely to advise individuals to visit them more often, which many individuals in the Seoul metropolitan area cannot afford to pay for.…”

Section: Differences Between the Characteristics Associated With Non-...mentioning

confidence: 99%

Characteristics Associated With Financial or Non-financial Barriers to Healthcare in a Universal Health Insurance System: A Longitudinal Analysis of Korea Health Panel Survey Data

Chung

2022

Front. Public Health

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While many studies have explored the financial barriers to healthcare, there is little evidence regarding the non-financial barriers to healthcare. This study identified characteristics associated with financial and non-financial barriers to healthcare and quantified the effects of these characteristics in South Korea, using a nationally representative longitudinal survey dataset. Overall, 68,930 observations of 16,535 individuals aged 19 years and above were sampled from Korea Health Panel survey data (2014–2018). From self-reported information about respondents' experiences of unmet healthcare needs, a trichotomous dependent variable—no barrier, non-financial barrier, and financial barrier—was derived. Sociodemographics, physical and health conditions were included as explanatory variables. The average adjusted probability (AAP) of experiencing each barrier was predicted using multivariable and panel multinomial logistic regression analyses. According to the results, the percentage of people experiencing non-financial barriers was much higher than that of people experiencing financial barriers in 2018 (9.6 vs. 2.5%). Women showed higher AAPs of experiencing both non-financial (9.9 vs. 8.3%) and financial barriers (3.6 vs. 2.5%) than men. Men living in the Seoul metropolitan area showed higher AAPs of experiencing non-financial (8.7 vs. 8.0%) and financial barriers (3.4 vs. 2.1%) than those living outside it. Household income showed no significant associations in the AAP of experiencing a non-financial barrier. People with a functional limitation exhibited a higher AAP of experiencing a non-financial barrier, for both men (17.8 vs. 7.8%) and women (17.4 vs. 9.0%), than those without it. In conclusion, people in South Korea, like those in most European countries, fail to meet their healthcare needs more often due to non-financial barriers than financial barriers. In addition, the characteristics associated with non-financial barriers to healthcare differed from those associated with financial barriers. This finding suggests that although financial barriers may be minimised through various policies, a considerable degree of unmet healthcare needs and disparity among individuals is very likely to persist due to non-financial barriers. Therefore, current universal health insurance systems need targeted policy instruments to minimise non-financial barriers to healthcare to ensure effective universal health coverage.

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“…Although it is well documented that hospital competition affects the quality and price of treatment, less is known about how competition affects SID. In addition, the literature shows both positive ( 5 ) and negative results ( 6 ) regarding the connection between competition and SID. Given the significant role of the market in the provision of healthcare, understanding the effect of competition on SID has substantial academic and practical value.…”

Section: Introductionmentioning

confidence: 99%

“…The first is the investigation into the connection between market competition and SID. Such studies frequently capture the degree of market competition based on the density of physicians ( 5 , 6 ) and estimate the level of SID through variations in the income of physicians ( 13 , 14 ). The findings of these studies are not entirely consistent.…”

Section: Introductionmentioning

confidence: 99%

How does market competition affect supplier-induced demand? An experimental study

Chen¹,

Pan²,

Ding³

2023

Front. Public Health

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IntroductionThis study investigated the impact of competition on supplier-induced demand in medical markets theoretically and experimentally.MethodsWe employed the framework of credence goods to describe the information asymmetry between physicians and patients, and theoretically derives predictions of physicians' behaviors in monopolistic and competitive markets. Then we conducted behavioral experiments to empirically test the hypotheses.ResultsThe theoretical analysis revealed that an honest equilibrium would not exist in a monopolistic market, whereas price competition could induce physicians to reveal their types of treatment cost and provide honest treatments; thus, a competitive equilibrium is superior to that of a monopolistic market. The experimental results only partially supported the theoretical predictions, which showed that the cure rate of patients in a competitive environment was higher than that in a monopolistic market, although supplier-induced demand occurred more frequently. In the experiment, the main channel through which competition improved market efficiency was increased patient consultations through low pricing, as opposed to the theory, which stated that competition would lead to physicians' honest treatment of patients through fair prices.DiscussionWe discovered that the divergence between the theory and the experiment stemmed from the theory's reliance on the assumption that humans are rational and self-interested, which means that they are not as price-sensitive as predicted by theory.

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Competition-driven physician-induced demand

Cited by 10 publications

References 21 publications

Changes in Barriers That Cause Unmet Healthcare Needs in the Life Cycle of Adulthood and Their Policy Implications: A Need-Selection Model Analysis of the Korea Health Panel Survey Data

Changes in Barriers That Cause Unmet Healthcare Needs in the Life Cycle of Adulthood and Their Policy Implications: A Need-Selection Model Analysis of the Korea Health Panel Survey Data

Characteristics Associated With Financial or Non-financial Barriers to Healthcare in a Universal Health Insurance System: A Longitudinal Analysis of Korea Health Panel Survey Data

How does market competition affect supplier-induced demand? An experimental study

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