Technological Adoption in Health Care

Barros, Pedro Pita; Martínez-Giralt, Xavier

doi:10.2139/ssrn.1589398

Cited by 5 publications

(3 citation statements)

References 29 publications

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“…Some analysts maintain that such incentives contribute to long-term growth in expenditure, because the development costs of these products must be recouped by industry (leading to higher prices) 6. Although much of this evidence originates from the US, Barros and Martinez-Giralt37 also found that payment systems affect the rate of technology adoption and utilization in European systems. National procurement policies and practices may also influence their diffusion into the health system and the costs associated with adoption.…”

Section: Resultsmentioning

confidence: 99%

Medical technology as a key driver of rising health expenditure: disentangling the relationship

Sorenson¹,

Drummond²,

B³

2013

CEOR

143

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Health care spending has risen steadily in most countries, becoming a concern for decision-makers worldwide. Commentators often point to new medical technology as the key driver for burgeoning expenditures. This paper critically appraises this conjecture, based on an analysis of the existing literature, with the aim of offering a more detailed and considered analysis of this relationship. Several databases were searched to identify relevant literature. Various categories of studies (eg, multivariate and cost-effectiveness analyses) were included to cover different perspectives, methodological approaches, and issues regarding the link between medical technology and costs. Selected articles were reviewed and relevant information was extracted into a standardized template and analyzed for key cross-cutting themes, ie, impact of technology on costs, factors influencing this relationship, and methodological challenges in measuring such linkages. A total of 86 studies were reviewed. The analysis suggests that the relationship between medical technology and spending is complex and often conflicting. Findings were frequently contingent on varying factors, such as the availability of other interventions, patient population, and the methodological approach employed. Moreover, the impact of technology on costs differed across technologies, in that some (eg, cancer drugs, invasive medical devices) had significant financial implications, while others were cost-neutral or cost-saving. In light of these issues, we argue that decision-makers and other commentators should extend their focus beyond costs solely to include consideration of whether medical technology results in better value in health care and broader socioeconomic benefits.

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Section: Resultsmentioning

confidence: 99%

Medical technology as a key driver of rising health expenditure: disentangling the relationship

Sorenson¹,

Drummond²,

B³

2013

CEOR

143

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“…Physicians' incentives to act on new information vary based on how they are compensated. Barros and Martínez-Giralt (2010) model adoption of a new technology under different reimbursement arrangements assuming that providers value their own financial performance and patient health. They show that when providers earn higher margins on the new technology, they may adopt the treatment even if it provides no benefit to patients.…”

Section: Reimbursement Incentivesmentioning

confidence: 99%

Comparative Effectiveness Research, COURAGE, and Technological Abandonment

Howard¹,

Shen²

2011

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“…Although some efforts have been made to interpret the empirical evidence concerning the diffusion of new technologies and the effect on the outcome of hospital care 2 , the literature has not yet contributed to a full understanding of how regulation should be used to ensure that adoption and use decisions of new health technologies are "good value (health) for money" over time. A contribution to the static dimension of the problem has been recently provided by Barros and Martinez-Giralt (2009), but the dynamic dimension is still almost unexplored, despite the awareness of its importance 3 . This rather scant interest is in sharp contrast with the concern that technological innovation is a major health care cost driver (Weisbrod, 1988) and that uncertainty on the performance of new technologies is often substantial at the outset (Gelijns and Rosenberg, 1994;McClellan, 1995).…”

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confidence: 99%

Static and dynamic efficiency of irreversible health care investments under alternative payment rules

Levaggi

Moretto²,

Pertile

2012

Journal of Health Economics

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SummaryThe paper studies the incentive for providers to invest in new health care technologies under alternative payment systems, when the patients' benefits are uncertain. If the reimbursement by the purchaser includes both a variable (per patient) and a lump-sum component, efficiency can be ensured both in the timing of adoption (dynamic) and the intensity of use of the technology (static). If the second instrument is unavailable, a trade-off may emerge between static and dynamic efficiency. In this context, we also discuss how the regulator could use the control of the level of uncertainty faced by the provider as an instrument to mitigate the trade-off between static and dynamic efficiency. Finally, the model is calibrated to study a specific technology. Keywords: Health Care, InvestmentsJEL Classification: I18, D92 (PRIN programme 2007(PRIN programme /2008 R. Levaggi and P. Pertile acknowledge the support from the Italian Ministry of Education AbstractThe paper studies the incentive for providers to invest in new health care technologies under alternative payment systems, when the patients' benefits are uncertain. If the reimbursement by the purchaser includes both a variable (per patient) and a lump-sum component, efficiency can be ensured both in the timing of adoption (dynamic) and the intensity of use of the technology (static). If the second instrument is unavailable, a trade-off may emerge between static and dynamic efficiency. In this context, we also discuss how the regulator could use the control of the level of uncertainty faced by the provider as an instrument to mitigate the trade-off between static and dynamic efficiency. Finally, the model is calibrated to study a specific technology.

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Technological Adoption in Health Care

Cited by 5 publications

References 29 publications

Medical technology as a key driver of rising health expenditure: disentangling the relationship

Medical technology as a key driver of rising health expenditure: disentangling the relationship

Comparative Effectiveness Research, COURAGE, and Technological Abandonment

Static and dynamic efficiency of irreversible health care investments under alternative payment rules

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