روشهای کنترل مخاطرات اخلاقی در نظام سلامت: مداخلات تقاضا و مداخلات عرضه (مقاله مروری)

  Background: Moral hazard is referred to behavior change of service-provider (physician) and service-consumer (patient) as the result of insurance. It is a serious concern for health insurance and insurance policies market in the health system reforms. Moral hazard usually leads to such unpleasant consequences as welfare loss, increasing health expenditures, decrease of insurance coverage, unnecessary use of resources, decrease of risk pooling benefits, as well as decrease in allocation and technical efficiency. There fore, in this review article, we want to describe the appropriate policy interventions to prevent moral hazard of consumers and healthcare providers.   Method: This is a review article. The related articles were taken from sound sites and reliable published texts. The databases such as Medline,Web of Science, Science Direct, Google Scholar, and Springer were explored based on appropriate key words used in current methods for moral hazard control in supply side and demand side.   Result: Demand policies only affect service demand on the part of patient, and do not impede extra service delivering on the part of service provider. So, more effort is needed from supply policies to monitor the use of extra services. In terms of demand aspect, such methods such as franchise, co-payment, waiting list, and encouragement for non-utilization are being used, while in terms of supply aspct, strategies like financial incentive and payment methods (fee-for-service, global payment), reform of source-providing system structures and behavior interventions (exclusive referring and gate-keeping, use of clinical-guidelines), and prospective supervision on use rate are being basically employed.   Conclusion: Different methods used to control moral hazards may prevent source waste, unnecessary services delivering, and misallocation of resources through preventing low-value consumptions. As a result, efficiency can be promoted and health expenditures can also be controlled.