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A moneymaking scan: Dual reimbursement systems and supplier‐induced demand for diagnostic imaging

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  • Véra Zabrodina
  • Mark Dusheiko
  • Karine Moschetti

Abstract

In complex health systems with growing healthcare spending, combining reimbursement systems that incentivize cost‐efficient healthcare provision within and across care sectors is key. This study investigates whether dual reimbursement systems lead hospitals to offset financial pressures in one care sector by inducing demand in another. We find that hospital imaging units induced demand for costly and unnecessary ambulatory imaging examinations reimbursed under fee‐for‐service, following a reform that introduced prospective payment and increased competition in the inpatient sector in Switzerland in 2012. Market structure, competitive pressures, and price regulations also influence demand inducement by varying the response to the reform. Reimbursement systems can influence supplier‐induced demand in other care sectors within hospitals where revenue is tied to the intensity of care provision. In particular, the possibility to self‐refer patients to high‐margin diagnostic examinations bears negative consequences on healthcare expenditures and potentially patient health.

Suggested Citation

  • Véra Zabrodina & Mark Dusheiko & Karine Moschetti, 2020. "A moneymaking scan: Dual reimbursement systems and supplier‐induced demand for diagnostic imaging," Health Economics, John Wiley & Sons, Ltd., vol. 29(12), pages 1566-1585, December.
  • Handle: RePEc:wly:hlthec:v:29:y:2020:i:12:p:1566-1585
    DOI: 10.1002/hec.4152
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    1. Chris Sampson’s journal round-up for 7th December 2020
      by Chris Sampson in The Academic Health Economists' Blog on 2020-12-07 12:00:03

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