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The Adoption and Use of Extracorporeal Shock Wave Lithotripsy by Hospitals in the United States

Published online by Cambridge University Press:  10 March 2009

Elaine J. Power
Affiliation:
Office of Technology Assessment, Washington, DC

Abstract

Extracorporeal shock wave lithotripsy (ESWL) for upper urinary stones has been in use in the United States since 1984. It was accepted immediately by hospitals and physicians, and its diffusion has been and continues to be rapid. Government payment and planning policies do not seem to have slowed this diffusion, although they have had some effect on the ownership of lithotripters and the manner in which ESWL is provided. An unintended but foreseeable result of ESWL's popularity with hospitals, physicians, and patients is that ESWL is not only rapidly replacing traditional surgery but is being used on many patients who would not have had surgery. It is likely that many more upper urinary stones are being treated aggressively now than before ESWL was introduced.

Type
Special Section: The Organization and Use of Technology in the Hospital Part II: Case Studies
Copyright
Copyright © Cambridge University Press 1987

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