Document Type : Original Article


1 Department of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran,

2 Department of Health Services Management, School of Public Health, Zabol University of Medical Sciences, Zabol

3 Department of Health Economic, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran

4 Epidemiology and Biostatistics, Tabriz University of Medical Sciences, Tabriz, Iran


BACKGROUND: Induced demand is a major challenge for financing health promotion, whereby
providers exploit patients’ information gap to manipulate their demand for health care. The purpose
of this study was to identify the factors associated with induced demand for health‑care services in
hospitals affiliated with Iran University of Medical Sciences (IUMS) in 2018.
MATERIALS AND METHODS: In this qualitative study, semi‑structured interviews were conducted
with 20 participants from IUMS hospitals, including faculty members, physicians, public hospital
managers, patients, and researchers with academic and practical experience. Inductive content
analysis was used to analyze the data.
RESULTS: Overall, 24 subthemes or factors were identified and classified into the health system,
the insurer, health‑care provider, and health‑care recipient themes. Poor monitoring and control,
the fee‑for‑service payment system, limited role of insurance companies, insufficient monitoring of
insurance companies, the educational nature of our health centers, health‑care providers’ interests,
and patients’ information gap were some important factors in induced demand for health‑care services.
CONCLUSION: Our results showed that there are many factors that contribute to induced demand for
health care. Given the four levels of factors identified in this study, health policymakers and managers
must develop strategies at each level to reduce induced demand for health care.


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