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The Distribution of “Big Ticket” Medical Technologies in OECD Countries

Published online by Cambridge University Press:  10 March 2009

Pablo Lázaro  and
Kathryn Fitch
Pablo Lázaro
Affiliation:
Instituto de Salud Carlos III and RAND
Kathryn Fitch
Affiliation:
Instituto de Salud Carlos III
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Abstract

Five “big ticket” medical technologies (BTTs) in 1990 were compared in the 24 OECD countries in relation to population, the number of physicians, gross domestic product (GDP), and health care expenditures (HCE). Wide variations were observed between and within countries for all measures. Regression analysis revealed that HCE explains part of the variation in the distribution of computed tomography scanners (excluding Japan), magnetic resonance imaging units, and radiation therapy units (R2 between 0.40 and 0.69), but not extracorporeal shock wave lithotripters. To a lesser extent, GDP was also found to correlate with the distribution of these technologies, but no correlation was found with number of physicians. Other factors affecting the diffusion of these technologies are proposed for study.

Type
General Essays
Information
International Journal of Technology Assessment in Health Care , Volume 11 , Issue 3 , Summer 1995 , pp. 552 - 570
Copyright
Copyright © Cambridge University Press 1995

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References

1.Agdestein, S., & Roemer, M. I.Good health at a modest price: The fruit of primary care. Journal of Public Health Policy, 1993, 13, 485–90.Google Scholar
2.Bäckman, G.Health policy in Finland: Organization, planning, and high technology development. International Journal of Technology Assessment in Health Care, 1988, 4, 375–84.CrossRefGoogle ScholarPubMed
3.Banta, H. D. International aspects of medical imaging. In NEMT (Nordic Evaluation of Medical Technology), Radiologin i Norden, Stockholm: SPRI 1990, 217–49.Google Scholar
4.Banta, H. D. Preface. In Lázaro, P. (ed.), Evaluation de servicios sanitarios: La alta tecnologia medica en España. Madrid, Spain: Fondo de Investigación Sanitaria, 1990, 37–43.Google Scholar
5.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.CrossRefGoogle ScholarPubMed
6.Beneken, J. E. W.The European scene of medical technology. Institute of Electrical and Electronics Engineers (IEEE) Engineering in Medicine and Biology, 1993, 12, 44–48.Google Scholar
7.Blendon, R. J., Donelan, K., Leitman, R., et al. Physicians' perspectives on caring for patients in the United States, Canada, and West Germany. New England Journal of Medicine, 1993, 328, 1011–16.Google Scholar
8.Blendon, R. J., Leitman, R., Morrison, I., & Donelan, K. Satisfaction with health systems in ten nations. Health Affairs, 1990, Summer, 185–92.Google Scholar
9.Blendon, R. J., & Moloney, T. W. Perspectives on the growing debate over the cost of medical technologies. In Altman, S. H. & Blendon, R. J. (eds.), Medical technology: The culprit behind health care costs? Proceedings of the 1977 Sun Valley Forum on National Health, 1977. 08 1–5, Washington, DC: U.S. Department of Health, Education, and Welfare, 1979.Google Scholar
10.Boothman, R. Medical technology in Ireland. In Stocking, B. (ed.), Expensive health technologies: Regulatory and administrative mechanisms in Europe. New York: Oxford University Press, 1988, 104–08.Google Scholar
11.Buch Andreasen, P. Medical technology in Denmark. In Stocking, B. (ed.), Expensive health technologies: Regulatory and administrative mechanisms in Europe. New York: Oxford University Press, 1988, 94–103.Google Scholar
12.Canadian Coordination Office for Health Technology Assessment. Lithotripters in Canada. CCOHTA Update, 1991, 9.Google Scholar
13.Canadian Coordination Office for Health Technology Assessment. Selected health technologies in Canada. Technology Brief, 1992, 5.0.Google Scholar
14.Center for Medical Technology Assessment. Some aspects on extracorporeal shock wave lithotripsy for renal and biliary stone treatment. Linköping, Sweden: Center for Medical Technology Assessment, Linköping University, 1991.Google Scholar
15.Chassin, M. R., Kosecoff, J., Park, R. E., et al. Does inappropriate use explain geographic variations in the use of health care services? Journal of the American Medical Association, 1987, 258, 2533–37.CrossRefGoogle ScholarPubMed
16.Council on Scientific Affairs and the Council on Medical Service, American Medical Association. Joint report of the Council on Scientific Affairs and the Council on Medical Service, Technology Assessment in Medicine. Archives of Internal Medicine, 1992, 152, 46–50.CrossRefGoogle Scholar
17.Danzon, P. M. Hidden overhead costs: Is Canada’s system really less expensive? Health Affairs, 1992, Spring, 21–43.CrossRefGoogle Scholar
18.Deber, R. B., Thompson, G. G., & Leatt, P.Technology acquisition in Canada: Control in a regulated market. International Journal of Technology Assessment in Health Care, 1988, 4, 185–206.CrossRefGoogle Scholar
19.Drummond, M. F. Financial incentives to change behavior towards health care technology. In Stocking, B. (ed.), Expensive health technologies: Regulatory and administrative mechanisms in Europe. New York: Oxford University Press, 1988, 61–77.Google Scholar
20.Drummond, M. F., Bloom, B. S., Carrin, G., et al. Issues in the cross-national assessment of health technology. International Journal of Technology Assessment in Health Care, 1992, 8,671–82.CrossRefGoogle ScholarPubMed
21.Durand-Zaleski, I., Reizine, D., Puzin, D., et al. Economic assessment of magnetic resonance imaging for inpatients: Is it still too early? International Journal of Technology Assessment in Health Care, 1993, 9, 263–73.CrossRefGoogle ScholarPubMed
22.Figley, M. M., & Margulis, A. R.The impact of new imaging technology on health care, research, and teaching: An international symposium. American Journal of Roentgenology, 1987, 149, 1111–26.CrossRefGoogle ScholarPubMed
23.France, G.Emerging policies for controlling medical technology in Italy. International Journal of Technology Assessment in Health Care, 1988, 4, 207–27.CrossRefGoogle ScholarPubMed
24.Fuchs, V. R., & Garber, A. M.The new technology assessment. New England Journal of Medicine, 1990, 323, 673–77.Google Scholar
25.Gerdtham, U. G. & Jönsson, B.Price and quantity in international comparisons of health care expenditure. Applied Economics, 1991, 23, 1519–28.CrossRefGoogle Scholar
26.Gerdtham, U. G., SØgaard, J.Andersson, F., & Jönsson, B.An econometric analysis of health care expenditure: A cross-section study of the OECD countries. Journal of Health Economics, 1992, 11, 63–84.CrossRefGoogle ScholarPubMed
27.Glaser, W. A.The competition vogue and its outcomes. Lancet, 1993, 341, 805–12.CrossRefGoogle ScholarPubMed
28.Göethlin, J. H. Cost/benefit of high technology in diagnostic radiology. In Chielsa, A., Gasparotti, R., & Maroldi, R. (eds.), Proceedings of the Fifth International Symposium on the Planning of Radiological Departments, April 20–23,1988, Florence, Italy. Brescia, Italy: Clas International, 1988, 258–62.Google Scholar
29.Gray, D., Hampton, J. R., & Bernstein, S. J.Clinical practice: Audit of coronary angiography and bypass surgery. Lancet, 1990, 335, 1317–20.Google Scholar
30.Groot, L. Medical technology in the Netherlands. In Stocking, B. (ed.), Expensive health technologies: Regulatory and administrative mechanisms in Europe. New York: Oxford University Press, 1988, 147–56.Google Scholar
31.Hailey, D. M., & Crowe, B. L.The introduction and evaluation of magnetic resonance imaging in Australia. Health Policy, 1991, 17, 25–37.Google Scholar
32.Halfpap, B.What does health really cost? Electromedica, 1986, 54, 19–30.Google Scholar
33.Health and Welfare Statistics Association. Health and welfare statistics in Japan. Tokyo, Japan, 1987.Google Scholar
34.Held, H. Medical technology in the Federal Republic of Germany. In Stocking, B. (ed.), Expensive health technologies: Regulatory and administrative mechanisms in Europe. New York: Oxford University Press, 1988, 116–21.Google Scholar
35.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
36.Hillman, B. J., Neu, C. R., Winkler, J. D., et al. Diffusion of magnetic resonance imaging into clinical practice. Santa Monica, CA: The RAND Corporation, 09, 1986.Google Scholar
37.Hitiris, T., & Posnett, J.The determinants and effects of health expenditure in developed countries. Journal of Health Economics, 1992, 11, 173–81.CrossRefGoogle ScholarPubMed
38.Hurst, J. W. Reforming health care in seven European nations. Health Affairs, 1991, Fall, 7–21.CrossRefGoogle Scholar
39.Ikegami, N.Health technology development in Japan. International Journal of Technology Assessment in Health Care, 1988, 4, 239–54.CrossRefGoogle ScholarPubMed
40.Ikegami, N.The economics of health care in Japan. Science, 1992, 258, 614–18.CrossRefGoogle ScholarPubMed
41.Ishikawa, K. B., Holt, M., Kahihara, S., et al. Performance, characteristics, and case mix in Japanese and American teaching hospitals. Medical Care, 1993, 31, 542–51.CrossRefGoogle ScholarPubMed
42.Jennett, B.Health technology assessment. British Medical Journal, 1992, 305, 67–68.CrossRefGoogle ScholarPubMed
43.Jennett, B.High technology medicine: Benefits and burdens. London: The Nuffield Provincial Hospital Trust, 1984.Google Scholar
44.Keeler, E. B., Brook, R. H., Goldberg, G. A., et al. How free care reduced hypertension in the Health Insurance Experiment. Journal of the American Medical Assocation, 1985, 254, 1926–31.CrossRefGoogle ScholarPubMed
45.Kirchberger, S.The diffusion of two technologies for renal stone treatment across Europe. London: King’s Fund Centre, 1991.Google Scholar
46.Lacronique, J. F. Medical technology in France. In Stocking, B. (ed.). Expensive health technologies: Regulatory and administrative mechanisms in Europe. New York: Oxford University Press, 1988, 109–15.Google Scholar
47.Lacronique, J. F.Technology in France. International Journal of Technology Assessment in Health Care, 1988, 4, 385–94.CrossRefGoogle ScholarPubMed
48.Lázaro, P.Evaluación de servicios sanitarios: La alta tecnologia médica en Espanña. Madrid: Fondo de Investigación Sanitaria, 1990.Google Scholar
49.Lázaro, P. The diffusion of medical technology. In Paine, L. (ed.), Hospital management international. London: International Hospital Federation, 1994, 356–57.Google Scholar
50.Levitt, T.The globalization of markets. Harvard Business Review, 1983, 61, 91–102.Google Scholar
51.Liu, K., Moon, M., Sulvetta, M., & Chawla, J.International infant mortality rankings: A look behind the numbers. Health Care Financing Review, 1992, 13, 105–18.Google Scholar
52.Lurie, N., Kamberg, C. J., Brook, R. H., & Newhouse, J. P. How free care improved vision in the Health Insurance Experiment. American Journal of Public Health, 1989, 79, 640–42.Google Scholar
53.McGregor, M.Technology and the allocation of resources. New England Journal of Medicine, 1989, 320, 118–20.Google Scholar
54.Ministere de la Solidarité, de la Santé, et de la Protection Sociale. Direction des Hopitaux. Les lithotripteurs en France. Paris: Bureau 48, 1989.Google Scholar
55.Ministere de la Solidarité, de la Santé, et de la Protection Sociale. Direction des Hopitaux. Les scanographes en France. Paris: Bureau 48, 1989.Google Scholar
56.Ministére de la Solidarité, de la Santé, et de la Protection Sociale. Informations hospitalieres. Paris, 1989.Google Scholar
57.National Health Technology Advisory Panel. Australian Institute of Health. CT scanning in Australia. Canberra: Australian Institute of Health, 1988.Google Scholar
58.National Health Technology Advisory Panel. Australian Institute of Health. High energy radiotherapy equipment. Canberra: Australian Institute of Health, 1989.Google Scholar
59.National Health Technology Advisory Panel. Australian Institute of Health. Magnetic resonance imaging services. Canberra: Australian Institute of Health, 1990.Google Scholar
60.Naylor, C.The Canadian health care system: A model for America to emulate? Health Economics, 1992, 1, 19–37.Google Scholar
61.Newhouse, J. P.Medical care costs: How much welfare loss? Journal of Economic Perspectives, 1992, 6, 3–21.CrossRefGoogle ScholarPubMed
62.OECD. OECD Health Data: A software package for the international comparison of health care systems. Version 1.01. Paris: OECD, 1991.Google Scholar
63.OECD. OECD Health Data: A software package for the international comparison of health care systems. Version 1.5. Paris: OECD, 1993.Google Scholar
64.Owen, J. B., Coia, L. R., & Hanks, G. E.Recent patterns of growth in radiation therapy facilities in the United States. International Journal of Radiation Oncology, Biology, Physics, 1991, 21(Suppl. 1), 223.Google Scholar
65.Pelfrene, E. Medical technology in Belgium. In Stocking, B. (ed.), Expensive health technologies: Regulatory and administrative mechanisms in Europe. New York: Oxford University Press, 1988, 89–93.Google Scholar
66.Perry, S., & Chu, F. A conflict: Medical innovation, access and cost containment. In Ekelman, K. B.(ed.), New medical devices: Invention, development, and use. Washington, DC: National Academy Press, 1988, 104–24.Google Scholar
67.Ramsey, S. D., Hillman, A. L., Renshaw, L. R., et al. How important is the scientific literature in guiding clinical decisions? The case of magnetic resonance. International Journal of Technology Assessment in Health Care, 1993, 9, 253–62.CrossRefGoogle ScholarPubMed
68.Richardson, J.Medical technology and its diffusion in Australia. International Journal of Technology Assessment in Health Care, 1988, 4, 407–31.Google Scholar
69.Rublee, D. A. Medical technology in Canada, Germany and the United States. Health Affaris, 1991, Fall, 180–81.Google Scholar
70.Rublee, D. A., & Schneider, M. International health spending: Comparison with the OECD. Health Affairs, 1991, Fall, 187–98.Google Scholar
71.Russell, L. B., & Sisk, J. E.Medical technology in the United States: The last decade. International Journal of Technology Assessment in Health Care, 1988, 4, 269–86.Google Scholar
72.Rutten, F., & Banta, D.Health care technologies in the Netherlands: Assessment and policy. International Journal of Technology Assessment in Health Care, 1988, 4, 229–38.Google Scholar
73.Saetnam, A. R., Backe, B., Kolstad, A., & Lamvick, T.Look to Norway! But not uncritically. International Journal of Technology Assessment in Health Care, 1988, 4, 359–74.CrossRefGoogle Scholar
74.Sargentini, A., Marino, F., & Bravar, D. Medical technology in Italy. In Stocking, B. (ed.), Expensive health technologies: Regulatory and administrative mechanisms in Europe. New York: Oxford University Press, 1988, 134-38.Google Scholar
75.Schieck, R. K.Trends in the diffusion of selected medical technology in the Federal Republic of Germany. International Journal of Technology Assessment in Health Care 1988, 4, 395–405.CrossRefGoogle Scholar
76.Schieber, G. J., & Poullier, J. O.Advancing the debate on international spending comparisons. Health Affairs, 199, Fall, 199–201.Google Scholar
77.Schieber, G. J., Poullier, J. P., & Greenwald, L. M. Health care systems in twenty-four countries. Health Affairs, 1991, Fall, 22–38.CrossRefGoogle Scholar
78.Schieber, G. J., Poullier, J. J., & Greenwald, L. M. Health spending, delivery, and outcomes in OECD countries. Health Affairs, 1993, Summer, 120–29.Google Scholar
79.Schieber, G. J., Poullier, J. P., & Greenwald, L. M.U.S. health expenditure performance: An international comparison and data update. Health Care Financing Review, 1992, 13, 1–87.Google ScholarPubMed
80.Sisk, J., Banta, H. D., Lukas, T. A., & Taylor, C. A. The computed tomography (CT) scanner. In Altman, S. H. & Blendon, R. J. (eds.), Medical technology: The culprit behind health care costs? Proceedings of the 1977 Sun Valley Forum on National Health, Aug 1–5, 1977. Washington, DC: U.S. Department of Health, Education, and Welfare, 1979, 116–43. Publication No. (PHS)79–3126.Google Scholar
81.Smith, V. H., & Bronzino, J. D.Measuring the cost of health care technologies. IEEE Engineering in Medicine and Biology, 1993, 12, 34–37.CrossRefGoogle Scholar
82.Stocking, B. Factors influencing the effectiveness of mechanisms to control medical technology. In Stocking, B. (ed.), Expensive health technologies: Regulatory and administrative mechanisms in Europe. New York: Oxford University Press, 1988, 19–25.Google Scholar
83.Stocking, B. Medical technology in the United Kingdom. In Stocking, B. (ed.), Expensive health technologies: Regulatory and administrative mechanisms in Europe. New York: Oxford University Press, 1988, 157–77.Google Scholar
84.Stocking, B.Medical technology in the United Kingdom. International Journal of Technology Assessment in Health Care, 1988, 4, 171–83.CrossRefGoogle ScholarPubMed
85.Stocking, B. Summary and conclusions. In Stocking, B. (ed.), Expensive health technologies: Regulatory and administrative mechanisms in Europe. New York: Oxford University Press, 1988, 78–85.Google Scholar
86.Terris, M. Global budgeting and the control of hospital costs. Journal of Public Health Policy, 1991 Spring, 61–71.CrossRefGoogle Scholar
87.Tsouros, A. Medical technology in Greece. In Stocking, B. (ed.), Expensive health technologies: Regulatory and administrative mechanisms in Europe. New York: Oxford University Press, 1988, 122-23.Google Scholar
88.Wagner, M. The many reasons why hospitals buy technology. Modern Health Care, 1990, 08 21–26.Google Scholar
89.Whitcomb, M. E.Health care technology acquisition: Issues and challenges. Health Technology, 1988, 2, 148–55.Google Scholar
90.Winslow, C. M., Kosecoff, J., Chassin, M., et al. The appropriateness of performing coronary artery bypass surgery. Journal of the American Medical Association, 1988, 260, 505–09.CrossRefGoogle ScholarPubMed
91.World Bank. World development report 1992. New York: Oxford University Press, 1992.Google Scholar
92.World Bank. World development report 1993. New York: Oxford University Press, 1993.Google Scholar