Mohammadshahi Marita, Yazdani Shahrooz, Olyaeemanesh Alireza, Akbari Sari Ali, Yaseri Mehdi, Emamgholipour Sefiddashti Sara
Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
Department of Cardiology, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran.
J Prev Med Public Health. 2019 Mar;52(2):72-81. doi: 10.3961/jpmph.18.238. Epub 2018 Dec 31.
The current study presents a new conceptual framework for physician-induced demand that comprises several influential components and their interactions.
This framework was developed on the basis of the conceptual model proposed by Labelle. To identify the components that influenced induced demand and their interactions, a scoping review was conducted (from January 1980 to January 2017). Additionally, an expert panel was formed to formulate and expand the framework.
The developed framework comprises 2 main sets of components. First, the supply side includes 9 components: physicians' incentive for pecuniary profit or meeting their target income, physicians' current income, the physician/population ratio, service price (tariff), payment method, consultation time, type of employment of physicians, observable characteristics of the physician, and type and size of the hospital. Second, the demand side includes 3 components: patients' observable characteristics, patients' non-clinical characteristics, and insurance coverage.
A conceptual framework that can clearly describe interactions between the components that influence induced demand is a critical step in providing a scientific basis for understanding physicians' behavior, particularly in the field of health economics.
本研究提出了一个关于医生诱导需求的新的概念框架，该框架包含几个有影响力的组成部分及其相互作用。
该框架是在拉贝尔提出的概念模型基础上开发的。为了确定影响诱导需求的组成部分及其相互作用，进行了一项范围综述（从1980年1月至2017年1月）。此外，成立了一个专家小组来制定和扩展该框架。
所开发的框架包括2组主要组成部分。第一，供给侧包括9个组成部分：医生对金钱利润或实现其目标收入的激励、医生的当前收入、医生与人口的比例、服务价格（收费标准）、支付方式、咨询时间、医生的就业类型、医生的可观察特征以及医院的类型和规模。第二，需求侧包括3个组成部分：患者的可观察特征、患者的非临床特征以及保险覆盖范围。
一个能够清晰描述影响诱导需求的各组成部分之间相互作用的概念框架，是为理解医生行为提供科学依据的关键一步，尤其是在卫生经济学领域。
