Medical Journal of the Islamic Republic Of Iran

en Demand-side Interventions to Control Moral Hazard in Health Systems, Beneficial or Detrimental: A Systematic Review Study Health Management and Economics Health Management and Economics Systematic Review Background: Moral hazard is one of the main reasons for health market failure where supply-side and demand-side interventions are used for its control and prevention. This study aimed to identify the effects of demand-side interventions on moral hazards in health systems.    Methods: For this systematic review, electronic databases, including Scopus, PubMed, Web of Science, Embase, ProQuest, Google Scholar’s search engine, and Iranian databases such as SID and Magiran, were investigated. No time limitation was considered in the search process. The narrative synthesis approach was used for data analysis.    Results: Out of 7484 retrieved papers, 61 papers were included in the study. The Identified effects were divided into 2 categories: health services consumption effects and financial effects, which were summarized in the form of advantages and disadvantages. The most important advantages included a decrease in the utilization of different services and a reduction in health expenditures. Also, the most important disadvantages included lower quality of care, shifting financing burden to the consumers, and limited access to necessary care.    Conclusion: The results showed that the most benefits of interventions, especially in cost-sharing and waiting list interventions, are for insurance organizations, where the disadvantages also affect consumers more. Therefore, it is necessary to pay more attention to these effects and their management because a lack of attention in this regard may impair the performance of insurance financial protection and health provision as one of the major goals of the health system. Demand-Side Intervention, Moral Hazards, Health Systems 491 502 http://mjiri.iums.ac.ir/browse.php?a_code=A-10-7377-1&slc_lang=en&sid=1 Zohreh Koohi Rostamkalaee koohi_r2006@yahoo.com 200319475328460070838 200319475328460070838 No 1. Department of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran Mehdi Jafari mjafari@iums.ac.ir 200319475328460070839 200319475328460070839 Yes Department of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran Hasan Abolghasem Gorji Gorji.h@iums.ac.ir 200319475328460070840 200319475328460070840 No Health Management Research Institute, Iran University of Medical Sciences, Tehran, Iran