Background: Supplier-induced demand (SID) refers to the concept that healthcare providers may deliver services that are not medically necessary to patients. An estimation of the extent to which this event has occurred can be insightful for policymaking and guiding health and insurance systems. This study aimed to investigate the extent of SID when performing a diagnostic ultrasonography for primary breast cancer patients and its relationship with socioeconomic factors in Iran.Methods: Data were obtained using questionnaires from 334 patients referred to the Cancer Research Center. To identify the patients who were candidates for undergoing a necessary diagnostic US, we employed the international clinical guidelines with confirmation of our expert panelists.With their assistance, a comprehensive index was created to screen those 'most probably affected by SID' .Results: 55.9% had undergone an unnecessary diagnostic ultrasonography, and thus were most probably affected by SID. A significant association between socioeconomic factors (education, occupation, and supplemental health insurance) and SID was confirmed (p value ≤ 0.001, 0.002, and 0.039, respectively).
Conclusion:This study supports the SID hypothesis and the unnecessary demand for diagnostic ultrasonography in
Context: Supplier-induced demand (SID) is an essential concept in health economics related to the diagnosis of different types of cancer and related expenditures. The current review considered studies on induced demand in cancer diagnosis. Evidence Acquisition: This systematic review investigated the induced diagnosis of cancer in four well-known databases (Scopus, Science Direct, Web of Science, and PubMed) from January 1980 to July 2019 using the keywords “induced demand,” “cancer,” and “diagnosis”. References of the studies found through the original search were also considered for analysis. Results: No studies focused on SID in cancer diagnosis could be found, thus indicating a significant deficiency in the discussion of SID in cancer diagnosis studies. Therefore, the terms most relevant to the concept of SID in cancer diagnosis were examined. Finally, 24 factors were categorized into three groups: economic, socio-cultural, and structural. The majority of evidence for the probability of SID in cancer diagnosis is related to overdiagnosis or early diagnosis caused by unnecessary screening (57.14% of reviewed articles) and the neglect of clinical practice guidelines (42.8% of reviewed articles), mainly by diagnostic imaging. Conclusions: Research focused explicitly on SID in cancer diagnosis is needed. Moreover, economic, social, and structural reforms related to the factors that connect overuse, overdiagnosis, and unnecessary services to cancer diagnosis are required to control costs and harm and provide the best benefits to patients.
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