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医疗保健中供应商诱导需求的主要因素:一项定性研究。

The main factors of supplier-induced demand in health care: A qualitative study.

作者信息

Seyedin Hesam, Afshari Mahnaz, Isfahani Parvaneh, Hasanzadeh Ebrahim, Radinmanesh Maryam, Bahador Rasoul Corani

机构信息

Department of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran.

Department of Health Services Management, School of Public Health, Zabol University of Medical Sciences, Zabol, Iran.

出版信息

J Educ Health Promot. 2021 Feb 27;10:49. doi: 10.4103/jehp.jehp_68_20. eCollection 2021.

Abstract

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.

摘要

背景

诱导需求是促进健康融资面临的一项重大挑战,即医疗服务提供者利用患者的信息差来操控其对医疗保健的需求。本研究旨在确定2018年伊朗医科大学(IUMS)附属医院中与医疗保健服务诱导需求相关的因素。

材料与方法

在这项定性研究中,对来自IUMS医院的20名参与者进行了半结构化访谈,其中包括教员、医生、公立医院管理人员、患者以及具有学术和实践经验的研究人员。采用归纳性内容分析法对数据进行分析。

结果

总体而言,共识别出24个次主题或因素,并将其分为卫生系统、保险公司、医疗服务提供者和医疗服务接受者主题。监管不力、按服务收费支付系统、保险公司作用有限、对保险公司监管不足、我们健康中心的教育性质、医疗服务提供者的利益以及患者的信息差是医疗保健服务诱导需求的一些重要因素。

结论

我们的结果表明,有许多因素导致了医疗保健诱导需求。鉴于本研究确定的四个因素层面,卫生政策制定者和管理人员必须在每个层面制定策略,以减少医疗保健诱导需求。

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