تعیین شرایط و نحوه تأثیر عوامل ایجادکننده تقاضای القایی برای بازارهای مراقبت‌های سلامت ایران

نوع مقاله : مقاله پژوهشی

نویسندگان

1 گروه اقتصاد بهداشت، دانشکده پزشکی، دانشگاه شاهد، تهران، ایران

2 بیمارستان فیروزگر، تهران، ایران

چکیده

هدف: در این پژوهش، تعیین شرایط و نحوه تأثیر عوامل ایجادکننده تقاضای القایی برای بازارهای مراقبت‌های سلامت ایران مورد بررسی قرار گرفت.
مواد و روش ها: برای ارزیابی وضعیت تقاضای القایی، شرایط تعادلی برای تقاضا و عرضه مراقبت‎های سلامت در مجموع 31 استان کشور و در یک دوره 6 ساله (سال‎های 1388-1393) مورد توجه قرار گرفته است. مدل‎های ارزیابی، براساس مدل رگرسیونی داده‎های پانلی در چارچوب مدل خطا- تصحیح با روش معادلات همزمان توضیح داده شده است. تخمین توابع تقاضا و تقاضای اضافی، در جامعه شهری تحت پوشش سازمان بیمه سلامت ایران، نتیجه ارزیابی برای تقاضای اضافی به صورت تقاضای القایی را نشان داده است.
نتایج: یافته‌های پژوهش نشان می‎دهد فراهم‎آورندگان مراقبت‎های سلامت سرپایی و بستری به عنوان کارگزار تقاضاکنندگان برای این مراقبت‎ها، شرایط تقاضای اضافی را مطابق با مدل عرضه‌کنندگان این مراقبت‌ها تعیین می‌نمایند.
نتیجه‌گیری: براساس مدل‌ها و یافته‎های پژوهش می‌توان جهت‎گیری‌های اساسی در سیاست‎گذاری‌ها برای کنترل تقاضای القایی در بازار سلامت کشور را شناسایی نمود.

کلیدواژه‌ها


عنوان مقاله [English]

Determining the conditions and the effect of factors causing induced demand for Iranian health care markets

نویسندگان [English]

  • Mahmoud Kazemian 1
  • Aazam Alvandi 2
1 Department of Health Economics, Faculty of Medicine, Shahed University, Tehran, Iran
2 Firoozgar Hospital, Tehran, Iran
چکیده [English]

Objective: In this study, determining the conditions and the effect of factors causing induced demand for Iranian health care markets was discussed.
Materials and Methods: To investigate the situation of induced demand, the equilibrium conditions of demand and supply of health care services in 31 Iranian provinces during 6 year (2009-2014) have been considered. The assessment model was expressed in terms of panel data regression within error correction framework. The estimation of demand and excess demand equation in the urban areas covered by the Iranian health insurance organization showed excess demand in certain forms of induced demand.
Results: Findings show that outpatient and inpatient health care providers, as agents of applicants for this care, determine the conditions of additional demand in accordance with the model of providers of this care.
Conclusion: Using the models and finding of this study, the policies for controlling the induced demand in the health care market could be recognized. 

کلیدواژه‌ها [English]

  • Induced demand
  • Asymmetry of information
  • Health care market
  • Agency for health sector
  1. Getzen TE, editor. Health economics: fundamentals and flow of funds. 2nd ed. New York: Wiley; 2004.
  2. Amir Esmaili1 M, Fatahpour A, Barooni M, Rafiee N. Reasons of induced demand in delivering services to the insured by health insurance: a case study in esfahan, 2013. Journal of Knowledge & Health 2017; 12(1): 1-7.
  3. Abdoli Gh, Varharami V. The role of asymmetric information in induced demands: a case study of medical services. Journal of Health Administration 2011; 14(43): 37-42.
  4. Bickerdyke I, Dolamore R, Monday I, Preston R, editors. Supplier-induced demand for medical services. Canberra: Productivity Commission Staff Working Paper 2002.
  5. Keyvanara M, Karimi S, Khorasani E, Jafarian jazi M. Challenges resulting from healthcare induced demand: a qualitative study. Health Information Management Journal 2013; 10(4): 538- 48.
  6. Carlsen F, Grytten J. Consumer satisfaction and supplier induced demand. Journal of Health Economics 2000; 19(5): 731-53.
  7. Dranove D, Wehner P. Physician-induced demand for childbirths. Journal of Health Economics 1994; 13(1):61-73.
  8. Akhavan Behbahani A, Esmaili I. Supplier-induced demand (sid) for medical services by Iranian physicians (policymaking and controlling). Majlis & Rahbord 2019; 25(96): 321-43.
  9. Mahbobi M, Ojaghi Sh, Ghiasi M, Afkar A. Supplemental insurances and induced demand in chemical veterans. Iranian Journal of War and Public Health 2010; 2(4): 18-22.
  10. Sekimoto M, Ii M. Supplier-induced demand for chronic disease care in Japan: multilevel analysis of the association between physician density and physician-patient encounter frequency. Value in Health Regional Issues 2015; (6): 103-10.
  11.  Panahi H, Salmani B, Nasibparast S. Inductive Effect of Physicians Number and Hospital Bed on Health Expenditures in Iran. Applied Theories of Economics 2015; 2(2): 25-42.
  12. Keyvanara M, Karimi S, Khorasani E. Perception of Experts Managers and Experts about Concept of “Induced Demand for Healthcare” in Isfahan [dissertation]. Isfahan: Isfahan University 2013.
  13. Bogg L, Diwan V, Vora KS, DeCosta A. Impact of Alternative Maternal Demand-Side Financial Support Programs in India on the Caesarean Section Rates: Indications of Supplier-Induced Demand. Maternal and Child Health Journal 2016; 20(1):11-15.
  14. Yuda M. Medical fee reforms, changes in medical supply densities, and supplier-induced demand: Empirical evidence from Japan. Hitotsubashi Journal of Economics 2013; 54(1): 79-93.
  15. Ansari B, Hoseini M, Bahadori M. Determinats of reduction of induced demand inselected hospitals that affiliated with iums in 2017; a qualitative study on provider’s view. Nursing and Midwifery Journal 2018; 16(6): 389-402.
  16. Kaiser B, Schmid C, editors. Does Physician Dispensing Increase Drug Expenditures. Switzerland: Universitat Bern 2013.
  17. Shigeoka H, Fushimi K. Supplier-induced demand for newborn treatment: evidence from japan. Journal of Health Economics 2014; 35: 162-78.
  18. Mohammadshahi M, Yazdani S, Olyaeemanesh A, Akbari Sari A, Yaseri M, Emamgholipour Sefiddashti S. A scoping review of components of physicianinduced demand for designing a conceptual framework. Journal of Preventive Medicine & Public Health 2019; 52(2): 72-81.
  19. Golkhandan A, Fatholahi E. Offering and testing a model to explain the physician induced demand in Iran. Journal of Healthcare Management 2017; 7(4): 29-40.
  20. Maeda T, Babazono A, Nishi T, Yasui M, HaranoY. Investigation of the existence of supplierinduced demand in use of gastrostomy among older adults: a retrospective cohort study. Medicine (Baltimore) 2016; 95(5): e2519.
  21. Shin H, Yoon J, Noh Y, Yeo JY. The Impact of Supplier Induced Demand on Increase in Medical Aid Expenditure. Health Policy and Management 2014; 24(1):13-23.
  22. Andrade E, de Andrade EN, Gallo JH. Case study of supply induced demand: the case of provision of imaging scans (computed tomography and magnetic resonance) at unimed-manaus. Revista da Associação Médica Brasilleira 2011; 57(2): 138-43.
  23. Varharami V. A Survey of Physician Induced- Demand. Semi- Annuaily Journal of Healtcare Management 2010; 2(1&2): 37-42.
  24. Schaumans C. Supplier inducement in the Belgian primary care market. http:// dx.doi.org/10.2139/ssrn.1021957.