فهرست مطالب شهرام غفاری

Induced demand refers to performing care or unnecessary services to patients or clients of the health system by applying power and ordering the specialists of the system. Induced demand arises as a result of various economic and structural factors, health market factors, and the behavior of service recipients and vendors. In our country, induced demand is one of the challenges of the health system; it increases the costs of the health sector and reduces its efficiency. One of the main challenges in the health system is the lack of causes of problems such as induced demand and its underlying factors. Explaining and analyzing this phenomenon can provide a clear perspective for decision-making. According to general health policies, prevention of induced demand for medicine and medical equipment and supplies is the responsibility of the Ministry of Health and Medical Education, but practical activities have not been done yet. Despite the need for national applied research, we found a few credible databases about this phenomenon and there were limited researches that do not answer the questions and challenges in basic decisions. The aim of this study was to explain the strategies to reduce induced demand in the country's health services.

This study was done by searching credible scientific and international references with the keyword "induced demand" and reviewing the available upstream documents, collected information on the definitions of induced demand and its effective causes, induced demand methods in medical services, challenges and how to control it. An expert panel was held with 23 specialist and national experts. Findings were collected and completed and analyzed qualitatively.

According to the findings, induced demand is a complex and multifactorial phenomenon that impairs the efficiency and allocation of national resources. In addition to upsetting the balance of supply and demand in the health market, it imposes additional costs on the patient and wastes time. This phenomenon sometimes leads to treatment and misdiagnosis and medical complications for health system client. Structural (causes related to organizational structure and service delivery, service recipients, and causes arising from insurance organizations) and social causes underlie the macro causes affecting induced demand.

Induced demand is the result of the interaction of individual, social and organizational factors that have social, health, and economic consequences for the community and can be prevented by using multiple strategies to prevent induced demand in health services.

The scarcity of resources and growing demand for health care, as well as moral, socioeconomic and political imperatives for efficient use of resources, make cost information and adoption of an accurate methodology an integral part of the modern management.

At first, a research protocol including literature review strategies, inclusion and exclusion criteria and data gathering methods, was designed. Afterwards, using an electronic search of several databases, some relevant studies were identified.

In the costing literature the economic and accounting approaches are distinguishable. Two methods of marginal and average unit cost analyses are attributable to these approaches. Considering the type of the problem to be decided about and cost targets, costing methods can be different. Factors such as types of cost analyses and economic evaluation, timing overview, analysis approach and advantage or disadvantage of economy of scale have a significant role in determining the costs.

Having no consensus of opinion on the most appropriate principles to use in costing process is one of the main challenges of the time. There is a trade-off between the accuracy and cost of achieving cost information... Therefore, standardization of costing methodologies and adoption of comprehensive approaches for the main issues will predispose an economical international and organizational comparability.

There are much more studies about adolescence in most countries in compare with other age groups. The goal of this study is evaluation of relationship between duration of hospitalization in elderly patients in comparison to the middle ages.Methods & Materials: This is a descriptive analysis, cross sectional, case study and retrospective research that was done after gathering the data of elderly and middle age patient in MILAD Hospital. First of all prevalent causes of admission in hospital has been detected. Descriptive analysis about tow important factors include: Duration of hospitalization and bed cost has been done. By statistical tests (T.Test, Analysis Of Variance-ANOVA- and other analytical test) the results had been analyzed and compared with similar researches.

In this study data of 12.989 patient has been analyzed (7,279 adolescent people with age range of 60±8.73 and 5,710 middle age people with age range of 45±4.17 which 6,430 were female and 6,559 were male). Based on this study the duration of hospitalization and bed costs of adolescents has been significantly more than middle age patients (P<0.001). As well, the bed costs of people between 60-75 years old has been significantly much more than other adolescents (P<0.001). Analysis showed that bed costs and duration of hospitalization has been significantly more in men than women (P<0.001).

1) Elderliness increases the duration of hospitalization, 2) The longest duration of hospitalization has been for 60-75 years old patients, 3) Duration of hospitalization was longer for men than women.