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荷兰理疗服务中的供方诱导需求。

Supplier-induced demand for physiotherapy in the Netherlands.

作者信息

Van Doorslaer E, Geurts J

出版信息

Soc Sci Med. 1987;24(11):919-25. doi: 10.1016/0277-9536(87)90285-1.

Abstract

Empirical studies of supplier-induced demand in health care have mostly concentrated on the analysis of physician behaviour. In this article, the focus is on the economic determinants of physiotherapist behaviour in The Netherlands. It is shown that relative prices work as strong incentives to alter the mix of services supplied, conform to the model of revenue maximization under a production constraint. However, the time-series analysis also gives some indication that this ability to influence the demand for their services to increase hourly income is not fully exploited. The latter finding is inconsistent with pure income maximization but rather points to a trade-off between loss of revenue and demand manipulation. The fact that the choice of therapy varies with the pressure on provider incomes does not cast some doubt on the appropriateness of the chosen patterns of treatment in terms of effectiveness.

摘要

医疗保健领域中关于供应商诱导需求的实证研究大多集中在对医生行为的分析上。在本文中,重点是荷兰物理治疗师行为的经济决定因素。研究表明,相对价格是改变服务供给组合的有力激励因素,符合生产约束下收益最大化模型。然而,时间序列分析也表明,这种通过影响服务需求来提高小时收入的能力并未得到充分利用。后一项发现与纯粹的收入最大化不一致,而是表明在收入损失和需求操纵之间存在权衡。治疗方式的选择随提供者收入压力而变化这一事实,并未对所选治疗模式在有效性方面的适当性产生一些质疑。

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