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Physician induced demand for knee replacement surgery in Iran.
Alinia, Cyrus; Takian, Amirhossein; Saravi, Nasser; Yusefzadeh, Hasan; Piroozi, Bakhtiar; Olyaeemanesh, Alireza.
Afiliação
  • Alinia C; Department of Health Economics and Management, School of Public Health, Urmia University of Medical Sciences, Urmia, Iran.
  • Takian A; Health Equity Research Center (HERC), Tehran University of Medical Sciences, Tehran, Iran. takian@tums.ac.ir.
  • Saravi N; Department of Global Health and Public Policy, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. takian@tums.ac.ir.
  • Yusefzadeh H; Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. takian@tums.ac.ir.
  • Piroozi B; Health Insurance Research Center, Armed Forces Medical Service Insurance Organization (AFMSIO), Tehran, Iran.
  • Olyaeemanesh A; Department of Health Economics and Management, School of Public Health, Urmia University of Medical Sciences, Urmia, Iran.
BMC Health Serv Res ; 21(1): 763, 2021 Aug 02.
Article em En | MEDLINE | ID: mdl-34340702
BACKGROUND: The structure of the Iranian health system has raised this hypothesis that a part of the Knee Replacement Surgery (KRS) services are provided due to Physician-Induced Demand (PID). METHODS: This paper used an unbalanced individual panel data covering the steady-state 15,729 KRSs performed by 995 surgeons provided by the Armed Forces Insurance Organization at the provincial level over the 60 months (2014-2018). We use a generalized method of moment's system (GMM-SYS) to obtain consistent and asymptotically efficient estimates, which provide a vital instrument for our dynamic panel data. RESULTS: The outcomes show that with unequal increasing orthopedic surgeons to population ratio, both the number and size of KRS services were increased significantly at a 1 % level. Given that the positive elasticity obtained for the service size was significantly larger than the number of services, the findings give strong support for the existence of PID in the Iran system for KRS care. Also, the raw and population-adjusted number of KRS, cost, and the surgery per active physician increased significantly at the monthly province level. CONCLUSIONS: This is the first time that the existence of PID in the Iranian health system is investigated using approved econometric models. The findings indicate that the health system structure has been provided the conditions for aggressive, costly, and high-risk services such as KRS to be exposed to PID.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Artroplastia do Joelho / Cirurgiões Tipo de estudo: Prognostic_studies Limite: Humans País/Região como assunto: Asia Idioma: En Ano de publicação: 2021 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Artroplastia do Joelho / Cirurgiões Tipo de estudo: Prognostic_studies Limite: Humans País/Região como assunto: Asia Idioma: En Ano de publicação: 2021 Tipo de documento: Article