Induced Demand after Implementing the Health Reform Plan in Selected Emergency Departments Affiliated to Isfahan University of Medical Sciences: a Cross-Sectional Study

Abstract

IntroductionExactly recognizing the effect of health reform plan (HRP) in emergency departments (EDs) is crucial given the large portion of budget assigned to this plan and the effect of introducing this plan on inducing demand and the associated potentially-unbearable costs. ObjectiveThe present study was conducted to assess the demand induced after implementing the HRP in the selected EDs of Isfahan University of Medical Sciences, Isfahan, Iran. MethodThe present quantitative and descriptive study collected data related to certain emergency services, performance indicators and working hours of emergency staff using a researcher-made checklist and based on hospital records and information in the years before and after implementing the HRP in Iran, i.e. 2013 and 2015. The data collected were analyzed in SPSS-21. ResultsThe obtained results suggested significant increases in emergency admissions (69.97%), radiographic images (65%), clinical tests (27.27%) and specialist visits (69.95%). Significantly increases observed in the performance indicators in the ED included the mean hospitalization duration by 61.14%, the bed occupancy rate by 15.71% and the working hours of the nursing staff by 11.43% and those of emergency medicine specialists by 44.72% in the first year after implementing the HRP compared to in the year before the implementation. ConclusionAlthough implementing the HRP in Iran significantly changed the performance indicators in the ED, certain infrastructure such as human resource management and the increased demand are considered the main time-consuming and costly challenges in EDs.