ABSTRACT
BACKGROUND: Diagnostic imaging fee had been reduced in May 2011, but it was recovered after 6 months because of strong opposition of medical providers. This study aimed to analyze the behavior of medical providers according to fee changes. METHODS: The National Health Insurance claims data between November 2010 and December 2012 were used. The number of exams per computed tomography was analyzed to verify that the fee changes increased or decreased the number of exams. Multivariate regression model were applied. RESULTS: The monthly number of exams increased by 92.5% after fee reduction, so the diagnostic imaging spending were remained before it. But medical provider decreased the number of exams after fee return. After adjusting characteristic of hospitals, fee reduction increased the monthly number of exams by 48.0% in a regression model. Regardless type of hospitals and severity of disease, the monthly number of exams increased during period of fee reduction. The number of exams in large-scaled hospitals (tertiary and general hospital) were increased more than those of small-scaled hospitals. CONCLUSION: Fee-reduction increased unnecessary diagnostic exams under the fee-for-service system. It is needed to define appropriate exam and change reimbursement system on the basis of guideline.
Subject(s)
Diagnostic Imaging , Fees and Charges , Insurance, Health , National Health ProgramsABSTRACT
Objective:To explain the supplier induced demand theory paradigm,track the empirical research progress,so as to provide references for health care reform in China.Methods:The new classical theory,game theory and behaviorism school were launched to process theoretical derivation of induced demand.The classical empirical research and the latest research progress were introduced to systemically review on supplier induced demand.Results:The generation of supplier induced demand was related with incentive system,the type of diseases and the crowd of research.Conclusion:It could effectively reduce the induced demand for health care that constraining hospital internal incentive,conducting medical supply side structural reform,developing the “Internet +medical” and building Diagnosis Related Groups (DRGs) payment system.
ABSTRACT
BACKGROUND: Supplier induced demand (SID) indicates the case when doctors increase the demand of the patients, following their (physicians') own best interests rather than patients'. This may occur when asymmetry of information exists between suppliers and consumers. This study aims to confirm whether SID exists in the Korean setting, particularly by dividing SID into both 'induced demand effect' and 'availability effect.' METHODS: Induced demand effect and availability effect are differentiated following Carlsen & Grytten's theoretical frame which divides doctor density regions into high and low ones. RESULTS: Positive correlation between doctors' density and utilization of their services was found, which could be interpreted as 'availability effect.' CONCLUSION: The result suggests that additional medical use for additional doctor, particularly in the area of low doctor density, can be interpreted to occur to meet the basic medical need of the people rather than as a result of unnecessary induced demand. It is important to make more medical doctors provided and to distribute them appropriately across the region in such a country like Korea where doctor's density is relatively low.
Subject(s)
Humans , Korea , Sudden Infant DeathABSTRACT
According to the theoretical basis of using 5 gripper models of health system reform and high-value policy designing process, to define the over-diagnosis and over-treatment in the process of basic health care utilization in public hospitals of China, basing on the diagnostic framework of the internal and external environment, to explore the causes herein and discriminate the root, direct and intermediate factors that lead to the problem systematically, and identify the formation mechanism of the problem.