Supplier-Induced Demand for Chronic Disease Care in Japan: Multilevel Analysis of the Association between Physician Density and Physician-Patient Encounter Frequency

Sekimoto, Miho; Masako,

doi:10.1016/j.vhri.2015.03.010

Cited by 33 publications

(35 citation statements)

References 17 publications

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“…The results of the present study showed that the majority of participants (65.2%) agreed with the existence of induced demand, which is consistent with previous studies [11][12][13][14][15] . Bogg et al showed that the government's financial support has led to induced demand 7 In Japan, Sekimoto and Ii studied the supply and induced demand for chronic diseases, and reported an increase in induced demand for hypertension and diabetes 24 . The findings of Crivellei et al in Switzerland 25 Delattre and Dormont in France 20 were in line with the results of this study.…”

Section: Discussionmentioning

confidence: 99%

Factors associated with induced demand for services in Iran’s healthcare system

et al. 2018

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Background: One of the most important subjects in health economics and healthcare management is the theory of induced demand; that is, caring for or providing and selling unnecessary services to users of healthcare systems, which is accompanied by the exercising of power by the service providers. Methods: This study was performed on physicians, nurses, and laboratory and radiology technicians working in Medical Science universities. Random sampling was conducted from five areas: the center, north, west, east and south of Iran. Data were gathered by a questionnaire, with a Cronbach's alpha of >0.7, consisting of nine dimensions on existence of induced demand and its associated factors. Results: The results showed that overall, 65.2% of the participants agreed with the existence of induced demand. Chi-squared test showed there was no difference in the level of induced demand between the regions of the country, education level and occupation. However, there was a significant difference in terms of gender (P<0.005). The Kruskal-Wallis test indicated a significant relationship between the associated factors and induced demand (P<0.005). Conclusions: Results showed that induced demand was influenced by factors including service recipients’ awareness, personal benefits of service providers, the extent they cared about health, supervision of insurance companies, industrialization of the health sector, diversity and increased number of trained experts and the quality of methods of training the service providers. Therefore, policymakers and planners should consider raising awareness of health service recipients, supervising insurance companies, reforming teaching methods, social culture making and changing the beliefs of society.

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Section: Discussionmentioning

confidence: 99%

Factors associated with induced demand for services in Iran’s healthcare system

et al. 2018

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“…18 Although SID has been studied for some time, its existence has not been proved because it is difficult to define the appropriate supply of care. 16 , 21 However, it has been reported that Japan has a higher proportion of gastrectomy among older adults than other countries, 3 , 4 which suggests an oversupply of gastrostomy procedures. Another challenge to detecting SID is that it is difficult to differentiate SID from patient preference.…”

Section: Discussionmentioning

confidence: 99%

“…We used physician density 21 by secondary tier of medical care (STM) as regional factors. STM is the unit of secondary care governed by a prefecture according to Japan's Medical Service Law.…”

Section: Methodsmentioning

confidence: 99%

Investigation of the Existence of Supplier-Induced Demand in use of Gastrostomy Among Older Adults

et al. 2016

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The aim of this study is to clarify whether there is small area variation in the use of gastrostomy that is explained by hospital physician density, so as to detect the existence of supplier-induced demand (SID).The study design is a retrospective cohort using claim data of Fukuoka Late Elders’ Health Insurance, submitted from 2010 to 2013. Study participants included 51,785 older adults who had been diagnosed with eating difficulties. We designated use of gastrostomy as an event. Multilevel logistic analyses were then used to investigate the existence of SID.After controlling for patient factors, we found significant regional level variance in gastrectomy use (median odds ratio [MOR]: 1.72, 1.37–2.51). Hospital physician density was significantly positively related with gastrostomy (adjusted OR of hospital physician density: 1.75, 1.25–2.45; P < 0.001). MORs were largely reduced for the input variable of hospital physician density.We found that the small area variation in use of gastrostomy among older adults could be explained by hospital physician density, which might indicate the existence of SID.

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“…3,5,6 Others suggest that it incents the delivery of unnecessary treatments. [7][8][9] The impact of increased competition on various patient outcomes has been explored in the literature. A systematic review conducted by Léonard et al 10 found that physician density, measured by the physician-to-population ratio, was positively associated with healthcare consumption.…”

Section: Introductionmentioning

confidence: 99%

“…Competition in health care has been studied in relation to different patient outcomes such as increase utilization rates, quality of care and cost. Sekimoto and Li, 8 Van Dijk et al 21 Our study presents the findings of a geospatial analysis, which aims to understand the influence of competition on dentists' clinical decision-making. It is part of a larger study aimed at understanding how different factors-environmental (competition), provider (age, gender, place of initial training, years of experience and perception of debt), practice (age of practice, number of hours worked/week, number of hygienists employed and number of patients seen/day) and patient factors (insurance status)-influence the clinical decision-making of dentists in Ontario, Canada's largest dental care market.…”

Section: Introductionmentioning

confidence: 99%

Does competition affect the clinical decision‐making of dentists? A geospatial analysis

Ghoneim

Lawrence

et al. 2019

Comm Dent Oral Epid

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Objectives To investigate the association between dentists' geographic density and perceptions of market competition with clinical decision‐making among a representative sample of dentists in Ontario, Canada's most populated province. Methods Competition was quantified using dentist density, defined as the number of dental clinics lying within a one kilometre radius around the respondents' clinic address and by self‐reported perceived pressure from other dental clinics. The outcome (clinical decision‐making or treatment intensity) was measured using a set of clinical scenarios, which categorized dentists as either relatively aggressive or conservative. Associations were assessed using bivariate analysis and logistic and linear regression. Results Dentists who perceived large competitive pressure from other dentists (OR = 1.63, 95% CI: 1.07‐2.49) were relatively more aggressive in their treatment choices. Interestingly, dentists located in very low dentist density areas (OR = 1.31, 95% CI: 1.03‐1.68) were also relatively more aggressive in their treatment choices. Conclusion This study is the first to explore the impact of competition on the clinical decision‐making of dentists in a Canadian context. It presents a valuable addition to the competition literature and helps to understand current dynamics in the Canadian dental care market.

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Supplier-Induced Demand for Chronic Disease Care in Japan: Multilevel Analysis of the Association between Physician Density and Physician-Patient Encounter Frequency

Abstract: The results of our study indicate the presence of SID in Japan. Further studies should investigate whether more frequent physician-patient encounters provide clinical advantages to patients.

Cited by 33 publications

References 17 publications

Factors associated with induced demand for services in Iran’s healthcare system

Factors associated with induced demand for services in Iran’s healthcare system

Investigation of the Existence of Supplier-Induced Demand in use of Gastrostomy Among Older Adults

Does competition affect the clinical decision‐making of dentists? A geospatial analysis

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