Consumer focused or system focused? Choosing demand management interventions.

Abstract

Because of its promise in cost containment, the area of Demand Management~ continues to grow and receive considerable recognition in health care2 and the public press. 3 While the popularity of the Demand Management approach has increased, and the volume of related products and services has expanded, little information has been presented in the recent literature about the variation in the underlying approaches, their value, and their impact. At present, the consistent theme among advertised Demand Management services is their goal to influence, and hopefully reduce, the volume of health care services provided? The Demand Management label is applied to a wide variety of activities that provide information, advice, or support to consumers. As such, it is possible to make broad assumptions about what all nurse-triage lines, audio text libraries, and online information services do. Yet, while the technologies and goals of many products appear the same, there are important philosophical differences to consider in choosing a service. One of the most fundamental differences among the products is the degree to which the individual consumer is encouraged to become more involved in the decision process. Some services influence the volume of services through barriers and financial disincentives, while others influence the volume of services by altering the individual’s perceived need for or value of the services. In the first case, the system imposes an external recommendation or restriction; in the other, the consumer is asked to become responsible for an appropriate course of action.