Investigation the Factors Related to Induced Demand for Patients with Cardiovascular Diseases

Due to the frequency, prevalence, and specific nature of cardiovascular diseases in our country, and the multiplicity, variety, complexity, and high cost of diagnostic and therapeutic services and equipment, the possibility of inducing demand in this category of diseases is higher. Using the partial least squares approach, this study aimed to test the factors affecting the induced demand in cardiovascular diseases, and provide a model of the relationship between these factors.

This was a library study with a systematic review of 49 articles, and then a survey of 118 people selected via random sampling method. First, a list of factors, sub-factors and components related to induced demand was extracted using qualitative content analysis technique; and then, using analysis technique, the path of the fitting model and the final model were validated by completing a validated questionnaire by physicians, experts, staff, and clients of Shahid Chamran Heart Hospital in Isfahan, Iran, in 2019.

Results:

In this study, 5 main factors, 18 sub-factors, and 82 items were obtained. In fitting the measurement model, the combined reliability coefficient, cross validity, convergent, and divergent the results of test was acceptable, and in structural fit model, path coefficients were significant, except for “patients” coefficient, at the 95% confidence, the mean model determination coefficient was 0.822 (strong), and the predictive fit index, except for the characteristics of medical services, was greater than 0.02 (acceptable). The result of the overall fit test was 0.133, which indicated the desirability of the overall fit of the model. The validity of the final model was confirmed with 77% agreement of experts.

Based on the findings of this study, it is necessary to adopt an appropriate policy at the macro-level to reform the network structure and referral and strengthen information management, and at the executive level, to modify payment methods, change tariffs and franchises for services, and change insurance methods and coverage.