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Research article
Zhongliang Zhou
Xi'an Jiaotong University
Corresponding Author
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Background Doing “more” in healthcare can be a major threat to the delivery of high-quality health care. It is important to identify the supplier-induced demand (SID) of health care. This study aims to test SID hypothesis by comparing health care utilization among patients affiliated with healthcare professionals and their counterpart patients not affiliated with healthcare professionals.
Methods We used coarsened exact matching to compare the health care utilization and expenditure between patients affiliated and not affiliated with healthcare professionals. Using the cross-sectional data of the China Labour-force Dynamics Survey (CLDS) in 2014, we identified 806 patients affiliated with healthcare professionals and 22788 patients not affiliated with healthcare professionals. The main outcomes were outpatient proportion and expenditure as well as inpatient proportion and expenditure.
Results The matched outpatient proportion of patients not affiliated with healthcare professionals was 0.6% higher (P=0.754) than that of their counterparts, and the matched inpatient proportion was 1.1% lower (P=0.167). Patients not affiliated with healthcare professionals paid significantly more (680 CNY or 111 USD, P<0.001) than their counterparts did per outpatient visit (1126 CNY [95% CI 885-1368] vs. 446 CNY [95% CI 248-643]), while patients not affiliated with healthcare professionals paid insignificantly less (2061 CNY or 336 USD, P=0.751) than their counterparts did per inpatient visit (15583 CNY [95% CI 12052-19115] vs. 17645 CNY [95% CI 4884-30406]).
Conclusion Our results lend support on supplier-induced demand hypothesis and highlight the need for policies to address the large outpatient care expenses of patients not affiliated with healthcare professionals. Our study also suggests that as the public becomes more informed, the demand of health care may persist while heath care expenditure per outpatient visit may decrease sharply due to the decline in supplier-induced demand. As significant misbehaviors performed by providers, it’s important to create right incentives to offer less avoidable healthcare service during outpatient visits may work to reduce healthcare costs.
Keywords
health care utilization, supplier-induced demand, China
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CURRENT STATUS: Published
View the published article at BMC Health Services Research.
No community comments so far
Editorial decision: Accept
On 01 Nov, 2020
Editor assigned
On 29 Oct, 2020
Submission checks complete
On 29 Oct, 2020
Editor invited
On 29 Oct, 2020
Version 4
Posted 28 Oct, 2020
No comments provided
Editorial decision: Minor revision
On 25 Oct, 2020
Editor assigned
On 20 Oct, 2020
Submission checks complete
On 19 Oct, 2020
Editor invited
On 19 Oct, 2020
No comments provided
Editorial decision: Minor revision
On 14 Oct, 2020
Review #3 received
Received 14 Oct, 2020
Review #1 received
Received 23 Sep, 2020
Reviewer #3 agreed
On 22 Sep, 2020
Reviewer #2 agreed
On 18 Sep, 2020
Review #2 received
Received 18 Sep, 2020
Editor assigned
On 17 Sep, 2020
Reviewers invited
Invitations sent on 17 Sep, 2020
Reviewer #1 agreed
On 17 Sep, 2020
Submission checks complete
On 16 Sep, 2020
Editor invited
On 16 Sep, 2020
No comments provided
Editorial decision: Minor revision
On 18 Aug, 2020
Review #3 received
Received 17 Aug, 2020
Review #2 received
Received 09 Aug, 2020
Review #1 received
Received 08 Aug, 2020
Reviewer #3 agreed
On 26 Jul, 2020
Reviewer #2 agreed
On 23 Jul, 2020
Reviewer #1 agreed
On 22 Jul, 2020
Editor assigned
On 22 Jul, 2020
Reviewers invited
Invitations sent on 22 Jul, 2020
Submission checks complete
On 21 Jul, 2020
Editor invited
On 21 Jul, 2020
No comments provided
Editorial decision: Major revision
On 09 Jun, 2020
Review #3 received
Received 04 Jun, 2020
Review #1 received
Received 31 May, 2020
Review #2 received
Received 31 May, 2020
Reviewer #4 agreed
On 14 May, 2020
Reviewer #2 agreed
On 10 May, 2020
Reviewer #3 agreed
On 10 May, 2020
Reviewers invited
Invitations sent on 09 May, 2020
Reviewer #1 agreed
On 09 May, 2020
Editor assigned
On 30 Apr, 2020
Submission checks complete
On 29 Apr, 2020
Editor invited
On 29 Apr, 2020
First submitted
On 28 Apr, 2020
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A new preprint design is coming!
We have improved readability, clarity, accessibility, and opportunities for engagement.
See the published version of this preprint at BMC Health Services Research.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Zhongliang Zhou
Xi'an Jiaotong University
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at BMC Health Services Research.
No community comments so far
Editorial decision: Accept
On 01 Nov, 2020
Editor assigned
On 29 Oct, 2020
Submission checks complete
On 29 Oct, 2020
Editor invited
On 29 Oct, 2020
Version 4
Posted 28 Oct, 2020
No comments provided
Editorial decision: Minor revision
On 25 Oct, 2020
Editor assigned
On 20 Oct, 2020
Submission checks complete
On 19 Oct, 2020
Editor invited
On 19 Oct, 2020
No comments provided
Editorial decision: Minor revision
On 14 Oct, 2020
Review #3 received
Received 14 Oct, 2020
Review #1 received
Received 23 Sep, 2020
Reviewer #3 agreed
On 22 Sep, 2020
Reviewer #2 agreed
On 18 Sep, 2020
Review #2 received
Received 18 Sep, 2020
Editor assigned
On 17 Sep, 2020
Reviewers invited
Invitations sent on 17 Sep, 2020
Reviewer #1 agreed
On 17 Sep, 2020
Submission checks complete
On 16 Sep, 2020
Editor invited
On 16 Sep, 2020
No comments provided
Editorial decision: Minor revision
On 18 Aug, 2020
Review #3 received
Received 17 Aug, 2020
Review #2 received
Received 09 Aug, 2020
Review #1 received
Received 08 Aug, 2020
Reviewer #3 agreed
On 26 Jul, 2020
Reviewer #2 agreed
On 23 Jul, 2020
Reviewer #1 agreed
On 22 Jul, 2020
Editor assigned
On 22 Jul, 2020
Reviewers invited
Invitations sent on 22 Jul, 2020
Submission checks complete
On 21 Jul, 2020
Editor invited
On 21 Jul, 2020
No comments provided
Editorial decision: Major revision
On 09 Jun, 2020
Review #3 received
Received 04 Jun, 2020
Review #1 received
Received 31 May, 2020
Review #2 received
Received 31 May, 2020
Reviewer #4 agreed
On 14 May, 2020
Reviewer #2 agreed
On 10 May, 2020
Reviewer #3 agreed
On 10 May, 2020
Reviewers invited
Invitations sent on 09 May, 2020
Reviewer #1 agreed
On 09 May, 2020
Editor assigned
On 30 Apr, 2020
Submission checks complete
On 29 Apr, 2020
Editor invited
On 29 Apr, 2020
First submitted
On 28 Apr, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at BMC Health Services Research.
Background Doing “more” in healthcare can be a major threat to the delivery of high-quality health care. It is important to identify the supplier-induced demand (SID) of health care. This study aims to test SID hypothesis by comparing health care utilization among patients affiliated with healthcare professionals and their counterpart patients not affiliated with healthcare professionals.
Methods We used coarsened exact matching to compare the health care utilization and expenditure between patients affiliated and not affiliated with healthcare professionals. Using the cross-sectional data of the China Labour-force Dynamics Survey (CLDS) in 2014, we identified 806 patients affiliated with healthcare professionals and 22788 patients not affiliated with healthcare professionals. The main outcomes were outpatient proportion and expenditure as well as inpatient proportion and expenditure.
Results The matched outpatient proportion of patients not affiliated with healthcare professionals was 0.6% higher (P=0.754) than that of their counterparts, and the matched inpatient proportion was 1.1% lower (P=0.167). Patients not affiliated with healthcare professionals paid significantly more (680 CNY or 111 USD, P<0.001) than their counterparts did per outpatient visit (1126 CNY [95% CI 885-1368] vs. 446 CNY [95% CI 248-643]), while patients not affiliated with healthcare professionals paid insignificantly less (2061 CNY or 336 USD, P=0.751) than their counterparts did per inpatient visit (15583 CNY [95% CI 12052-19115] vs. 17645 CNY [95% CI 4884-30406]).
Conclusion Our results lend support on supplier-induced demand hypothesis and highlight the need for policies to address the large outpatient care expenses of patients not affiliated with healthcare professionals. Our study also suggests that as the public becomes more informed, the demand of health care may persist while heath care expenditure per outpatient visit may decrease sharply due to the decline in supplier-induced demand. As significant misbehaviors performed by providers, it’s important to create right incentives to offer less avoidable healthcare service during outpatient visits may work to reduce healthcare costs.
Figure 1
This is a list of supplementary files associated with this preprint. Click to download.
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