The economic consequences of practice style variation in providing medical interventions: A systematic review of the literature
نویسندگان
1 Health Economics Department, School of Health Management and Information Sciences, Iran University of Medical Sciences
2 Health Economics Department, School of Health Management and Information Sciences, Iran University of Medical Sciences, Health Management and Economics Research Center‚ Iran University of Medical Sciences‚ Tehran, Iran
3 Health Management Research Center‚ Baqiyatallah University of Medical Sciences
4 Health Economics Department, School of Health Management and Information Sciences, Iran University of Medical Sciences
5 Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences
6 Health Economics Department, National Institute of Health Research, Tehran University of Medical Sciences Health Equity Research Center, Tehran University of Medical Sciences, Tehran, Iran
doi
چکیده
The practice style variation (PSV) incurs undesirable clinical and economic consequences for patientsand the healthcare system. This review aims to analyze the economic consequences of PSV inmedical interventions. A comprehensive electronic search was conducted through PubMed, Web ofSciences, EBSCO, EMBASE, and Cochrane databases to retrieve studies on economic consequencesof PSV within 1975–2018. The studies were independently assessed by two reviewers. The qualityof studies was assessed by Strengthening the Reporting of Observational Studies in Epidemiologychecklist. No language restriction was applied. Only four studies met the eligibility criteria. Thesestudies have been conducted retrospectively in developed countries. Most of the included studiesused consumer demand theory to measure the economic consequences of PSV. Findings showed12%–74% of all variations in healthcare services are related to PSV, thereby incurring up to 23 milliondollars for the healthcare system. The PSV is related to the total expenditure, price elasticity, andcoefficient of variation of healthcare services. PSV associated with huge inefficiency and inequity inaccess to healthcare services. To mitigate the consequences of PSV, policymakers should considerPSV in both developing the medical education plans as well as cost management. Using multilevelanalysis to investigate the determinants of PSV would be beneficial.
