Technology Diffusion and Productivity Growth in Health Care

Abstract

We draw on macroeconomic models of diffusion and productivity to explain empirical patterns of survival gains in heart attacks. Using Medicare data for 2.8 million patients during 1986–2004, we find that hospitals rapidly adopting cost-effective innovations such as beta blockers, aspirin, and reperfusion, had substantially better outcomes for their patients. Holding technology adoption constant, the marginal returns to spending were relatively modest. Hospitals increasing the pace of technology diffusion (“tigers”) experienced triple the survival gains compared to those with diminished rates (“tortoises”). In sum, small differences in the propensity to adopt effective technology lead to wide productivity differences across hospitals.

Hospital treatment rates and spillover effects: Does ownership matter?

“…We find a tendency for some hospitals to favor high technologies or use intense treatments rather than less intense treatments as suggested in Skinner and Staiger (2009) and Chandra and Staiger (2007). Teaching hospitals provide more medication but less PCI.…”

Healthcare Exceptionalism? Performance and Allocation in the U.S. Healthcare Sector

“…This approach is standard in the literature as a way of purging measures of care utilization of administrative price variation (see e.g. Skinner and Staiger, 2015;Gottlieb et al, 2010). Nonetheless, it is a highly imperfect measure of inputs, as it does not reflect actual inputs used but rather CMS-defined expected inputs based on the treatment approach chosen.…”

Investigating the effects of ICT on innovation and performance of European hospitals: an exploratory study

“…However, ICT is measured by two types of health information technology: Electronic Medical Records (EMR) and clinical decision support, that is, only by a limited spectrum of available hospital ICT applications. 5 We refrain here from surveying empirical literature that deals with the influence of technology and innovation in general on productivity in health care (see, e.g., Skinner and Staiger 2009;Baltagi et al 2012;Lichtenberg 2013). McCullough et al (2010) examined the relationship between six process-quality measures (such as the percentage of smokers with heart failure and pneumonia, respectively, who were given smoking cessation advice, the percentage of pneumonia patients assessed and given pneumococcal vaccination if indicated; the percentage of pneumonia patients given the most appropriate initial antibiotic, etc.)…”