Strategies for reducing induced demand in the health system: A scoping review

Induced demand is the phenomenon where healthcare providers, especially physicians, stimulate demand for unnecessary healthcare services by exerting their influence on patients. Induced demand increases healthcare expenditure and reduces healthcare system efficiency. Therefore, this study aimed to identify strategies for reducing induced demand in the healthcare system.

In the present scoping review, all published articles on strategies to reduce induced demand in the healthcare system until February 11, 2023, were searched and collected from nine English and Farsi databases and the Google Scholar search engine. Finally, 36 documents were reviewed and analyzed using MAXQDA software.

Overall, 44 strategies to reduce induced demand in the healthcare system were identified  and grouped into three levels: macro (healthcare system), meso (healthcare organizations), and micro (healthcare providers and recipients). The most frequent strategies to reduce induced demand included using an appropriate referral system, following clinical guidelines, adopting fixed and pay-for-performance methods of payment to healthcare providers, setting a ceiling on the number of services physicians can offer, enforcing healthcare providers’ compliance with medical ethics, training healthcare providers and recipients, and monitoring and control.

Induced demand for health services has a complex nature and is influenced by the behavior of policymakers, healthcare providers, payers, and patients. Therefore, strategies to reduce induced demand should be applied at the three levels of healthcare system, healthcare organizations, and healthcare providers and recipients to achieve better results.