Provider–client interactions and quantity of health care use

BACKGROUND: Induced demand is a major challenge for financing health promotion, whereby providers exploit patients' information gap to manipulate their demand for health care. The purpose of this study was to identify the factors associated with induced demand for health-care services in hospitals affiliated with Iran University of Medical Sciences (IUMS) in 2018. MATERIALS AND METHODS: In this qualitative study, semi-structured interviews were conducted with 20 participants from IUMS hospitals, including faculty members, physicians, public hospital managers, patients, and researchers with academic and practical experience. Inductive content analysis was used to analyze the data. RESULTS: Overall, 24 subthemes or factors were identified and classified into the health system, the insurer, health-care provider, and health-care recipient themes. Poor monitoring and control, the fee-for-service payment system, limited role of insurance companies, insufficient monitoring of insurance companies, the educational nature of our health centers, health-care providers' interests, and patients' information gap were some important factors in induced demand for health-care services. CONCLUSION: Our results showed that there are many factors that contribute to induced demand for health care. Given the four levels of factors identified in this study, health policymakers and managers must develop strategies at each level to reduce induced demand for health care.

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“…list the number of competitors in the market as a supply-side factor in induced demand for health care. [ 21 ]…”

Section: Discussionmentioning

confidence: 99%

“…showed that epidemiological shifts, evolution of needs, demographic changes, and variation in tastes affect induced demand for health care. [ 21 34 ]…”

Section: Discussionmentioning

confidence: 99%

The main factors of supplier-induced demand in health care

Seyedin

Afshari

Isfahani

et al. 2021

Journal of Education and Health Promotion

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“…Disturbances in the balance of supply and demand in the market for health services may encourage specialists to advertise unnecessary medical services to attract more patients. Lien et al remarked that the number of competitors in the market is an important factor in creating SID (29).…”

Section: Discussionmentioning

confidence: 99%

Main Factors Leading to Supplier-Induced Demand in Iran: A Comprehensive Review

et al. 2020

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Context: Supplier-induced demand (SID) is one of the challenges of health systems, leading to unbearable expenses, particularly for people. Objectives: The present study aimed to investigate the factors leading to SID in Iran. Data Sources: The present study is a comprehensive systematic review focusing on studies of SID up to the end of May 2018 in six English databases, five Persian databases, and two search engines. The exclusion criteria were publications in languages other than Persian and English and publications after May 2018. Data Extraction: A data extraction form was used to record authors' names and specifications, year of publication, the city of the study, language, purpose, methodology, data collection method, and factors influencing the induced demand. The risk of bias was assessed using a standard risk of bias tool. Results: We found 514 papers. Eventually, 16 papers met the inclusion criteria, and they were selected for the study. We found 11 papers in the Persian language and five articles in English. The design of 37.5% of the articles was qualitative, 31.25% analytical, 25% descriptive-analytical, and 6.25% descriptive. Factors influencing SID were classified at four levels including meta-level (Ministry of Health and Medical Education (MoHME)), macro-level (universities of Medical Sciences), meso-level (service providers), and micro-level (patients). Conclusions: According to the results of this research, creating SID can lead to serious challenges for health systems, service providers, patients, and insurance organizations. Therefore, health managers and policymakers need to design appropriate strategies such as adopting the evidence-based approach to purchasing services by the insurer and approval of standards and rules to reduce such SID.

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“…In this regard, Richardson and Peacock claimed that medical decision-making is often complex and uncertain even if all medical standards were met 28 . Lien et al also stated that the development of needs, epidemiological changes and diversity of tastes have further complicated patient diagnosis and treatment, and the distinction between real and induced demand 29 . It seems that the implementation of healthcare reform in Iran and significant reductions in patients' out-of-pocket payments have resulted in increased demand for services.…”

Section: Discussionmentioning

confidence: 99%

Factors associated with induced demand for services in Iran’s healthcare system

et al. 2018

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Background: One of the most important subjects in health economics and healthcare management is the theory of induced demand; that is, caring for or providing and selling unnecessary services to users of healthcare systems, which is accompanied by the exercising of power by the service providers. Methods: This study was performed on physicians, nurses, and laboratory and radiology technicians working in Medical Science universities. Random sampling was conducted from five areas: the center, north, west, east and south of Iran. Data were gathered by a questionnaire, with a Cronbach's alpha of >0.7, consisting of nine dimensions on existence of induced demand and its associated factors. Results: The results showed that overall, 65.2% of the participants agreed with the existence of induced demand. Chi-squared test showed there was no difference in the level of induced demand between the regions of the country, education level and occupation. However, there was a significant difference in terms of gender (P<0.005). The Kruskal-Wallis test indicated a significant relationship between the associated factors and induced demand (P<0.005). Conclusions: Results showed that induced demand was influenced by factors including service recipients’ awareness, personal benefits of service providers, the extent they cared about health, supervision of insurance companies, industrialization of the health sector, diversity and increased number of trained experts and the quality of methods of training the service providers. Therefore, policymakers and planners should consider raising awareness of health service recipients, supervising insurance companies, reforming teaching methods, social culture making and changing the beliefs of society.

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Provider–client interactions and quantity of health care use

Cited by 10 publications

References 31 publications

The main factors of supplier-induced demand in health care

The main factors of supplier-induced demand in health care

Main Factors Leading to Supplier-Induced Demand in Iran: A Comprehensive Review

Factors associated with induced demand for services in Iran’s healthcare system

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