Supplier Induced Demand for Selected Services

Abstract

Abstract Background and purpose: The health reform plan is a program in Iran's health system. The implementation of this plan led to changes in the payment system as well as changes in service tariffs and pricing. These changes in the long term caused the consumption and provision of unnecessary services and induced demand by service providers. Objective: The purpose of this study was to investigate the amount of induced demand using the relationship between service tariff changes and health care prescriptions. Method: First, services were selected based on tariff changes. Then it was classified based on the type of service and years and the type of service provider, then for each of the services, per capita consumption and per capita cost, number and cost of services were estimated based on the type of service provider. Finally, the effect of each of the variables of tariff and ownership of service providers and insurance coverage on the number of services was investigated. Findings: The per capita consumption and per capita cost for the services of "uterine and ovarian ultrasound" increased, "ureteral dilatation with stone crushing" decreased, "nasal septum repair" increased, "knee arthroscopy" increased and "catheter placement in the vein" decreased after the transformation plan. The effect of the tariff and the ownership of service providers on the increase in the number of services has been evaluated positively, and insurance coverage, except for rural insurance, has also achieved positive results. Conclusion: Based on the results obtained in this research, there is a direct relationship between tariff changes and the type of insurance fund and the ownership of service providers with changes in the number and cost of services consumed after the health transformation plan, which requires investigation of changes the rules at themacrolevel.