Volume 9, Issue 31 (3-2018)                   jemr 2018, 9(31): 165-196 | Back to browse issues page

XML Persian Abstract Print

Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:

Panahi H, Fallahu F, Imani A, Nasibparast S. Investigating Psychiatrists Induced Demand in East Azarbayjan:The Approach of Hierarchical Linear Modeling (HLM). jemr 2018; 9 (31) :165-196
URL: http://jemr.khu.ac.ir/article-1-1637-en.html
1- Tabriz University
2- Tabriz University , simanasibparast@yahoo.com
Abstract:   (4306 Views)
In recent decades, unnecessary growth in health expenditures of developing countries, and the importance of physicians' behavior in health market, have made investigating determinants of health expenditure on the one hand and the theory of physician induced demand (PID) on the other, as two of the most important issues in health economics. Therefore, using data collected through filling out information collection forms by psychiatrists and patients of East Azarbayjan in 2016 and employing hierarchical linear modeling methods (HLM), this study, examines the determinants of the average expenditure of each visit to a doctor and investigates the theory of PID within psychiatrists in the East Azarbayjan province. The results show that in psychiatry, although psychiatrists are “doctors tend to profit”, there is no physician induced demand. Results also indicate that patiant’s income, patiant’s education level, and condition of illness have significant effects on the average expenditure of each visit to a doctor. According to these results, it is suggested that in order to reduce unnecessary health expenditure, patient information on medical care should be increased, and government monitoring and control over the national health system must be increased.
Full-Text [PDF 771 kb]   (1477 Downloads)    
Type of Study: Applicable | Subject: سایر
Received: 2017/11/14 | Accepted: 2018/05/8 | Published: 2018/06/13

1. Abdoli, Gh. (2008) Determinants of Medical Costs in Social Security Organization, Journal of Social Welfare, 7 (27): 235-252. (In Persian)
2. Abdoli, Gh, Varahrami, V. (2012) The Role of Asymmetric Information in Induced Demands: A Case Study of Medical Services, Journal of Health Management, 14(43): 37-42. (In Persian)
3. Ahmadi, A. M., & Taheri, E. (2017) Factors Affecting Health Expenditures of Households in Iran: Application of Ordered Probit Model, Journal of Health Administration, 2 (67): 89-98. (In Persian)
4. Ashraf Toor, I., and Butt, M. S. (2005) Determinants of Healthcare Expenditure in Pakistan, Pakistan Economic and Social Review, (1): 133-155.
5. Blumenthal, D., Causino, N., Chang, Y., Culpepper, L., Marder, W., Saglam, P., Stafford, R., & Starfield, B. (1999) The Duration of Ambulatory Visits to Physicians, Journal of Family Practice, 48(4): 264-271.
6. Chaabouni, S., and Abednnadher, C. (2014) The Determinants of Health Expenditures in Tunisia: An ARDL Bounds Testing Approach, International Journal of Information Systems in the Service Sector, 6 (4): 60-72. [DOI:10.4018/ijisss.2014100104]
7. Darziramandi, S, Shahnazi, R., Aboutorabi, M., Niakan, L., & Kavosi, Z. (2018) Physician-Induced Demand Hypothesis in Iran: Impact of the Physician Density on Treatment Costs, Insurance Research, 32 (4): 1-19. (In Persian)
8. Dranove D., & Wehner P. (1994) Physician-Induced Demand for Childbirths, Journal of Health Economics, 13: 61-73. [DOI:10.1016/0167-6296(94)90004-3]
9. Emadzadeh, M., Samadpour, N., Ranjbar, H., & Azizi, F. (2014) The Impact of Education on Health in Iran: A Production Function Approach, Journal of Economic Modeling Research, 4 (15): 147-178. (In Persian)
10. Farley, P. (1986) Theories of The Price and Quantity of Physician Services, Health Economics, 5: 315-333. [DOI:10.1016/0167-6296(86)90007-X]
11. Fuchs V. (1978) The Supply of Surgeons and The Demand for Operations, Journal of Human Resources, 13: 35-56. [DOI:10.2307/145247]
12. Grytten, J., & Sørensen, R. (2001) Type of Contract and Supplier-Induced Demand for Primary Physicians in Norway, Journal of Health Economics, 20: 379-393. [DOI:10.1016/S0167-6296(00)00087-4]
13. Hosoya, K. (2014) Determinants of Health Expenditures: Stylized Facts and a New Signal, Modern Economy, 5: 1171-1180. [DOI:10.4236/me.2014.513109]
14. Jaegher, K., & Jegers, M. (2000) A Model of Physician Behavior With Demand Inducement, Journal of Health Economics, 19: 231-258. [DOI:10.1016/S0167-6296(99)00029-6]
15. Jürges, H. (2007) Health Insurance Status and Physician-Induced Demand for Medical Services in Germany: New Evidence From Combined District and Individual Level Data, MEA-Universität Mannheim L13, 17, 68131 Mannheim, Germany. [DOI:10.2139/ssrn.1092811]
16. Kazemian, M.; Investigating Induced Demand in Healthcare Market of Iran; MSc Dissertation. Faculty of Medical Sciences: University of Shahed, 2016. (In Persian).
17. Keyvanara M., Karimi S., Khorasani E., and Jazi Jafarian, M. (2013) Challenges of Induced Demand for Health Services: A Qualitative Study, Health Information Management, 10 (4). (In Persian).
18. Khani, M.; Investigating Physician Induced Demand (Case Study: C-Section in Iran); MSc Dissertation. Faculty of Management and Economics: University of Sharif, 2013. (In Persian).
19. Lefevre, M. (2014) Physician Induced Demand for C-sections: Does the Convenience Incentive Matter? Health, Econometrics and Data Group (HEDG), Working Papers from HEDG, Department of Economics, University of York. [DOI:10.2139/ssrn.2310646]
20. Liao, Chia-Cheng; Evidence of Physician (Supplier) Induced Demand and Physician Altruism; Doctoral Thesis. Wayne State University: Detroit, Michigan, 2009.
21. Magazzino C, Mele M. (2012) The Determinants of Health Expenditure in Italian Regions, International Journal of Economics and Finance, 4(3): 61-72. [DOI:10.5539/ijef.v4n3p61]
22. McGuire, T. G. (2000) Physician Agency. Culyer A. J., Newhouse J. P. (eds), The Handbook of Health Economics, North-Holland: Amsterdam, 461-536. [DOI:10.1016/S1574-0064(00)80168-7]
23. Mehrara M, & Fazaeli A. (2009) A Study on Health Expenditures in Relation with Economics Growth in Middle East and North Africa (MENA) Countries, Journal of Health Administration, 12 (35): 49-60. (In Persian).
24. Migongo, Alice W., Charingo, Richard, M. Love, Margaret (2012) Factors Relating to Patient Visit Time with a Physician, Medical Decision Making, 32: 93-104. [DOI:10.1177/0272989X10394462]
25. Nguyen, L., Hakkinen, U., Pekurinen, M., Rosenqvist, G. and Mikkola, H. (2009) Determinants of Health Care Expenditure in a Decentralized Health Care System, National Institute for Health and Welfare, Discussion Papers 21/2009, Helsinki: Finland.
26. Petek Ster, Marija, Svab, Igor, & Kalan, Gordana Zivcec (2008) Factors Related to Consultation Time: Experience Slovenia, Journal of Primary Health Care, 26(1): 29-34. [DOI:10.1080/02813430701760789]
27. Panahi, H., Salmani, B., & Nasibparast, S. (2015) Inductive Effect of Physicians Number and Hospital Bed on Health Expenditures in Iran, Journal of Applied Theories of Economics, 2 (2): 15-42. (In Persian)
28. Rezayi, H., Alizadeh, M., & Nademi, Y. (2017) Effective Factors on Per Capita Healthcare Expenditure: A Comparison of Spatial Models in Selected Developing Countries, Journal of Applied Theories of Economics, 4 (2): 1-26. (In Persian)
29. Roemer, M I. (1961) Bed Supply & Hospital Utilization: A National Experiment Hospitals, J.A.H.A., 35: 988-993.
30. Rosenberg, B. (1973) Linear Regression with Randomly Dispersed Parameters, Biometrika, 60: 61-75. [DOI:10.2307/2334906]
31. Sadeghi, S. K., Motafekker Azad, M. A., & Jalilpour, S. (2014) Investigating Main Determinants of Private Healthcare Expenditure and Their Effects Between Different Income Levels in Asian Countries, Social Welfare, 14(53): 55-75.
32. Samadi, A., and Homaie Rad, E. (2013) Determinants of Healthcare Expenditure in Economic Cooperation Organization (ECO) Countries: Evidence from Panel Cointegration Tests, Health Policy and Management, 1(1): 63-68. [DOI:10.15171/ijhpm.2013.10]
33. Sekimoto, M., and Li, M. (2015) Supplier-Induced Demand for Chronic Disease Care in Japan: Multilevel Analysis of the Association Between Physician Density and Physician-Patient Encounter Frequency, Value in Health Regional, 6C: 103-110. [DOI:10.1016/j.vhri.2015.03.010]
34. Shain M, & Roemer M I. (1959) Hospital Costs Relate to the Supply of Beds, Modern Hospital, 92: 71-73.
35. Shigeoka, H. & Fushimi, K., Supply Induced Demand in Newborn Treatment: Evidence from Japan. [2013] Online: http://ssrn.com/abstract=2174758.
36. Sobhanian, S. M. H., Mehrara, M., & Ebadi, J. (2017) Study of Factors in Fluencing Physician Decision to Enter the Family Physician Program; A Case Study of Tehran, Journal of Economic Modeling Research, 7 (26): 7-40. (In Persian) [DOI:10.18869/acadpub.jemr.7.26.7]
37. Sorensen, R. & Grytten, J. (1999) Competition and Supplier-Induced Demand in a Health Care System with a Fixed Fee, Health Economics, 8: 497-508. https://doi.org/10.1002/(SICI)1099-1050(199909)8:6<497::AID-HEC439>3.3.CO;2-4 [DOI:10.1002/(SICI)1099-1050(199909)8:63.3.CO;2-4]
38. Suzuki R., Medical Expenditures of Outpatients and the Physician/Population Ratio, Research Report for the Research Project on Analysis of Claim Data of Medical Care for the Elderly, Foundation for Public Health Promotion, 1997.
39. Tai-Seal, Ming, McGuire, Thomas G., & Zhang, Weimin (2007) Time Allocation in Primary Care Office Visits. Health Services Research, 42(5): 1871-1894. [DOI:10.1111/j.1475-6773.2006.00689.x]
40. Varahrami, V. (2010) Investigating Physician Induced Demand, Healthcare Management, 2(1 & 2): 37-42.
41. Vekov, T. J., Aleksandrova-Yankulovska, S. S., Grancharova, G. G., Veleva, N. R. & Draganova, M. T. (2011) Induced Demand for Hospital Services in Bulgaria-Trends and Contributing Factors, Financial Management.
42. Wilinsky A. (1993) Competition in a market for informed experts' services, RAND Journal of Economics, 24: 380-398. [DOI:10.2307/2555964]

Add your comments about this article : Your username or Email:

Send email to the article author

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

© 2023 CC BY-NC 4.0 | Journal of Economic Modeling Research

Designed & Developed by : Yektaweb