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A Comparison of the Investment in Hospital-Based Obstetrical Ultrasound in Wales and Washington State

Published online by Cambridge University Press:  10 March 2009

Roger A. Rosenblatt ,
Andrew J. Dawson ,
Eric H. Larson ,
Carolyn J. Tressler ,
Anthony Jones ,
L. Gary Hart  and
Thomas S. Nesbitt
Roger A. Rosenblatt
Affiliation:
University of Washington School of Medicine
Andrew J. Dawson
Affiliation:
Neville Hall Hospital
Eric H. Larson
Affiliation:
University of Washington School of Medicine
Carolyn J. Tressler
Affiliation:
University of Washington School of Medicine
Anthony Jones
Affiliation:
University of Wales College of Medicine
L. Gary Hart
Affiliation:
University of Washington School of Medicine
Thomas S. Nesbitt
Affiliation:
University of California at Sacramento
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Abstract

The purpose of this study was to examine differences in the way Britain and the United States invest in and deploy a new medical technology. We used structured interviews to obtain information on the technical sophistication and approximate replacement value of all hospital-based obstetrical ultrasound machines in every maternity hospital in Washington state and Wales. The supply of hospital-based ultrasound machines—approximately two machines per 1,000 births—was similar in both countries. Wales had fewer advanced ultrasound machines than Washington state, and they were based exclusively in high-volume district general hospitals; there were no obstetric ultrasound machines in the private sector. In Washington state, the majority of advanced machines were in small and medium-sized hospitals, and many private offices had ultrasound machines. The approximate replacement value of hospital-based machines was three times as high per birth in Washington state as in Wales. In the case of obstetrical ultrasound, centralization of facilities, a relatively small private sector, and global budgeting lead to lower expenditures per patient within the National Health Service without compromising access to care.

Type
General Essays
Information
International Journal of Technology Assessment in Health Care , Volume 11 , Issue 3 , Summer 1995 , pp. 571 - 584
Copyright
Copyright © Cambridge University Press 1995

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References

1.Achiron, R., Glaser, J., Gerlernter, I., Hegesh, J., & Yagel, S.Extended fetal echocardiographic examination for detecting cardiac malformations in low risk pregnancies. British Medical Journal, 1992, 304, 671–74.CrossRefGoogle ScholarPubMed
2.Altman, S. A., & Blendon, R. (eds). Medical technology: The culprit behind health care costs? Washington, DC: U.S. Government Printing Office, 1979. DHEW publication (PHS) 70–3216.Google Scholar
3.Banta, H. D., & Kemp, K. B. (eds). The management of health care technology in nine countries. New York: Springer Publishing Company, 1982.Google Scholar
4.Battista, R. N.Innovation and diffusion of health-related technologies: A conceptual framework. International Journal of Technology Assessment in Health Care, 1989, 5, 227–48.Google Scholar
5.Belfrage, P., Fernstrom, I., & Hallenberg, G.Routine or selective ultrasound examinations in early pregnancy. Obstetrics and Gynecology, 1987, 69, 747–50.Google ScholarPubMed
6.Bennett, M. J., Little, G., Dewhurst, J., & Chamberlain, G.Predictive value of ultrasound measurement in early pregnancy: A randomized controlled trial. British Obstetrics and Gynaecology, 1982, 89, 338–41.Google Scholar
7.Clark, L., Mugford, M., & Paterson, C.How does the mode of delivery affect the cost of maternity care? British Obstetrics and Gynaecology, 1991, 98, 519–23.Google Scholar
8.D’Alton, M. E., & DeCherney, A. H.Prenatal diagnosis. New England Journal of Medicine, 1993, 328, 114–20.Google ScholarPubMed
9.Eddy, D. M.What do we do about costs? Journal of the American Medical Association, 1990, 264, 1161–65.Google Scholar
10.Ewigman, B. G., Crane, J. P., Frigoletto, F. D., et al. Effect of prenatal ultrasound screening on perinatal outcome: RADIUS Study Group. New England Journal of Medicine, 1993, 329, 821–87.Google Scholar
11.Hendee, W. R.Technology assessment in medicine: Methods, status and trends. Medical Progress through Technology, 1991, 17, 69–75.Google Scholar
12.Hillman, B. J., Joseph, C. A., Mabry, M. R., et al. Frequency and costs of diagnostic imaging in office practice: A comparison of self-referring and radiologist-referring physicians. New England Journal of Medicine, 1990, 323, 1604–08.CrossRefGoogle Scholar
13.Hoare, J.Tidal wave: New technology, medicine, and the NHS: Proceedings of the Caversham Conference on Health Technology Assessment, London: The King’s Fund Centre,1992.Google Scholar
14.Johansen, K. S., & Racoveanu, N. T.Big ticket technology: Is rational utilization possible? Medical Progress through Technology,1991,17, 85–91.Google ScholarPubMed
15.Kaczmarek, R. G., Moore, R. M., & Bright, R. A.The relationship of maternal race and insurance status to prenatal ultrasound use in a national population. Maryland Medical Journal,1992, 41,139–43.Google Scholar
16.Larson, E. H., Hart, L. G., & Rosenblatt, R. A.Rural residence and poor birth outcome in Washington State. Journal of Rural Health, 1992, 8, 162–70.CrossRefGoogle ScholarPubMed
17.Minor, A. F.The cost of maternity care and childbirth in the United States, 1989. Research Bulletin R1589. Washington, DC: Health Insurance Association of America, 12 1992.Google Scholar
18.Moore, R. M., Jeng, L. L., Kaczmarek, R. G., & Placek, P. J.Use of diagnostic ultra sound, x-ray examinations, and electronic fetal monitoring in perinatal medicine. Journal of Perinatology, 1990, 10, 361–65.Google Scholar
19.National Institutes of Health Consensus Development Conference. Consensus Statement: Diagnostic Ultrasound in Pregnancy. Washington, DC: U.S. Government Printing Office, 1984.Google Scholar
20.Parkin, D. W., McGuire, A. J., & Yule, B. F.What do international comparisons of health care expenditures really show? Community Medicine, 1989, 11, 116–23.Google Scholar
21.Royal College of Obstetricians and Gynaecologists Working Party. Routine Ultrasound Examination in Pregnancy. London: Royal College of Obstetricians and Gynaecologists, 1984.Google Scholar
22.Schieber, G. J., & Pouillier, J. P. International health spending: Issues and trends. Health Affairs, 1991, Spring, 106–16.CrossRefGoogle Scholar
23.Sheldon, T. A., Smith, G. D., & Bevan, G.Weighting in the dark: Resource allocation in the new NHS. British Medical Journal, 1993, 306, 835–39.CrossRefGoogle ScholarPubMed
24.Showstack, J. A., Schroeder, S. A., & Matsumoto, M. F.Changes in the use of medical technologies, 1972–1977: A study of 10 inpatient diagnoses. New England Journal of Medicine, 1982, 306, 706–12.CrossRefGoogle ScholarPubMed
25.Stocking, B. The management of medical technology in the United Kingdom. In: Banta, H. D. & Kemp, K. B. (eds.) The management of health care technology in nine countries. New York: Springer Publishing Company, 1982, 11–27.Google Scholar
26.Susser, M.Health as a human right: An epidemiologist's perspective on the public health. American Journal of Public Health, 1993, 83, 418–26.Google Scholar
27.Switzer, P. J., James, C. A., & Freitag, M. A.Value and limitations of obstetrical ultrasound. Canadian Family Physician, 1992, 38, 121–27.Google ScholarPubMed
28.Wagner, M.Ultrasound evolution. Modern Healthcare, 1992, 22, 26–30.Google ScholarPubMed
29.Welch, W. P., Miller, M. E., Welch, H. G., et al. Geographic variation in the expenditure for physicians' services in the United States. New England Journal of Medicine, 1993, 328, 621–27.Google Scholar
30.Wells, P. N. T., Garrett, J. A., & Jackson, P. C.Assessment criteria for diagnostic imaging technologies. Medical Progress through Technology 1991, 17, 93–101.Google Scholar