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Unnecessary Ultrasonography As Supplier-Induced Demand in Diagnosis of Primary Breast Cancer in Iran: A Cross-Sectional Study Publisher Pubmed



Akbari M1, 2 ; Arani AA1 ; Sahabi B3 ; Olyaeemanesh A4 ; Noorian S5
Authors
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Authors Affiliations
  1. 1. Economic Development and Planning Department, Faculty of Management and Economics, Tarbiat Modares University, Tehran, Iran
  2. 2. Cancer Research Centre, Shahid Beheshti University of Medical Science, Tehran, Iran
  3. 3. Economics Department, Faculty of Management and Economics, Tarbiat Modares University, Tehran, Iran
  4. 4. National Institute for Health Research and Health Equity Research Centre, Tehran University of Medical Sciences, Tehran, Iran
  5. 5. Department of Statistics, Faculty of Science, University of Qom, Qom, Iran

Source: International Journal of Health Planning and Management Published:2022


Abstract

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 primary breast cancer. Also, our evidence indicates imposing excessive costs that can positively influence the policymakers' decision-making in the healthcare systems. © 2021 John Wiley & Sons Ltd.
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