Match!

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

Published on May 1, 2013in ClinicoEconomics and Outcomes Research
· DOI :10.2147/CEOR.S39634
Corinna Sorenson14
Estimated H-index: 14
(LSE: London School of Economics and Political Science),
Michael Drummond73
Estimated H-index: 73
,
Bhuiyan Khan B1
Estimated H-index: 1
Abstract
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.
  • References (100)
  • Citations (54)
📖 Papers frequently viewed together
206 Citations
903 Citations
78% of Scinapse members use related papers. After signing in, all features are FREE.
References100
Newest
Inefficiency in the U.S. health care system has often been characterized as "flat of the curve" spending providing little or no incremental value. In this paper, we draw on macroeconomic models of diffusion and productivity to better explain the empirical patterns of outcome improvements in heart attacks (acute myocardial infarction). In these models, small differences in the propensity to adopt technology can lead to wide and persistent productivity differences across countries -- or in our cas...
63 CitationsSource
#1Corinna Sorenson (LSE: London School of Economics and Political Science)H-Index: 14
#2Michael DrummondH-Index: 73
Correspondence: Corinna Sorenson LSE Health, London School of Economics and Political Science, London, UK Tel +44 (0)20 7955 7397 Fax +44 (0)20 7955 6803 Email c.sorenson@lse.ac.uk Abstract: With continued technological advances in orthopedic devices and increasingly limited health care resources, greater attention will be placed on substantiating the socioeconomic value of these devices. Therefore, this study focused on a systematic review of available economic evaluations of selected orthopedi...
2 CitationsSource
#1William T. Obremskey (Vandy: Vanderbilt University)H-Index: 32
#2Teresa L. Dail (VUMC: Vanderbilt University Medical Center)H-Index: 2
Last. A. Alex Jahangir (Vandy: Vanderbilt University)H-Index: 12
view all 3 authors...
Background Health care in the United States is known for its continued innovation and production of new devices and techniques. While the intention of these devices is to improve the delivery and outcome of patient care, they do not always achieve this goal. As new technologies enter the market, hospitals and physicians must determine which of these new devices to incorporate into practice, and it is important these devices bring value to patient care. We provide a model of a physician-engaged p...
12 CitationsSource
#1Corinna Sorenson (LSE: London School of Economics and Political Science)H-Index: 14
#2Rosanna Tarricone (Bocconi University)H-Index: 22
Last. Michael DrummondH-Index: 73
view all 4 authors...
Medical devices pose unique challenges for economic evaluation and associated decision-making processes that differ from pharmaceuticals. We highlight and discuss these challenges in the context of cardiac device therapy, based on a systematic review of relevant economic evaluations. Key challenges include practical difficulties in conducting randomized clinical trials, allowing for a ‘learning curve’ and user characteristics, accounting for the wider organizational impacts of introducing new de...
36 CitationsSource
#1Corinna Sorenson (LSE: London School of Economics and Political Science)H-Index: 14
#2Panos Kanavos (LSE: London School of Economics and Political Science)H-Index: 35
Procurement policy can influence the diffusion of medical devices into national health systems, but limited comparative evidence exists on how countries procure such technologies. This paper discusses the procurement of select medical devices across five countries (England, France, Germany, Italy, and Spain) based on a review of published and grey literature and policy documents, as well as expert interviews. All countries have introduced various regulatory or policy measures that implicitly or ...
45 CitationsSource
Objectives: The aim of this study was to present and illustrate an instrument to measure the level of innovation at country level. Methods: The data used are the Organisation for Economic Co-operation and Development (OECD) health data 2009, in particular the information on use of medical technology. Two composite scales expressing a relative level of adoption of innovations in health care are regressed, using multilevel regression analysis, on country characteristics. The country characteristic...
6 CitationsSource
#1Pedro Pita Barros (NOVA: Universidade Nova de Lisboa)H-Index: 23
#2Xavier Martinez-Giralt (Autonomous University of Barcelona)H-Index: 7
This paper addresses the impact of payment systems on the rate of technology adoption. We present a model where technological shift is driven by demand uncertainty, increased patients' benefit, financial variables, and the reimbursement system to providers. Two payment systems are studied: cost reimbursement and (two variants of) DRG. According to the system considered, adoption occurs either when patients' benefits are large enough or when the differential reimbursement across technologies offs...
6 CitationsSource
#1Amy BernsteinH-Index: 14
#2Linda T. BilheimerH-Index: 7
Last. Diane M. MakucH-Index: 28
view all 3 authors...
207 Citations
Preface Technological Change & Growth of Health Care Spending The Long-Term Outlook for Health Care Spending Index.
45 Citations
#1Jonas Schreyögg (Technical University of Berlin)H-Index: 25
#2Michael Bäumler (Technical University of Berlin)H-Index: 3
Last. Reinhard Busse (Technical University of Berlin)H-Index: 48
view all 3 authors...
Dramatic increases in health expenditures have led to a substantial number of regulatory interventions in the markets for devices over the last years. However, little attention has been paid thus far to the regulation of medical devices and its effects. This article explores the policies pursued by European countries to find the right balance between improving access to new medical devices and restricting market forces to contain costs and ensure affordability. We outline the medical device poli...
50 CitationsSource
Cited By54
Newest
#1Carlos A Castañeda-Orjuela (National University of Colombia)H-Index: 41
Last. Fernando De la Hoz Restrepo (National University of Colombia)H-Index: 22
view all 3 authors...
Healthcare costs are a concern for the sustainability of health systems in both rich and poor countries. Achieving a balance between the aspirations of payers and the manufacturers of new technologies is a challenge for democratic societies. Evidence about the efficacy and effectiveness of a new intervention is a fundamental aspect for its inclusion, but additional information about organization, implementation, and feasibility is required. Economic evaluations, especially cost-effectiveness ana...
1 CitationsSource
#1Sara Jamalabadi (UHH: University of Hamburg)H-Index: 1
#2Vera Winter (UHH: University of Hamburg)H-Index: 4
Last. Jonas Schreyögg (UHH: University of Hamburg)H-Index: 25
view all 3 authors...
BACKGROUND: Limited empirical evidence exists regarding the effect of price changes on hospital behavior and, ultimately, the quality of care. Additionally, an overview of the results of prior literature is lacking. OBJECTIVE: This study aims to provide a synthesis of existing research concerning the relationship between hospital cost/price and the quality of care. METHODS: Searches for literature related to the effect of hospital cost and price on the quality of care, including studies publishe...
Source
#1Roberto Moro Visconti (CUA: The Catholic University of America)H-Index: 8
#1Roberto Moro Visconti (CUA: The Catholic University of America)
Last. Donato MoreaH-Index: 4
view all 2 authors...
This study aims to explore the impact of healthcare digitalization on smart hospital project financing (PF) fostered by pay-for-performance (P4P) incentives. Digital platforms are a technology-enabled business model that facilitates exchanges between interacting agents. They represent a bridging link among disconnected nodes, improving the scalable value of networks. Application to healthcare public–private partnerships (PPPs) is significant due to the consistency of digital platforms with healt...
Source
#1Daniel Pinto (NU: Northwestern University)H-Index: 11
#2Mauricio Garnier (Marquette University)H-Index: 1
Last. Allen W. Heinemann (NU: Northwestern University)H-Index: 45
view all 12 authors...
Background We know little about the budget impact of integrating robotic exoskeleton over-ground training into therapy services for locomotor training. The purpose of this study was to estimate the budget impact of adding robotic exoskeleton over-ground training to existing locomotor training strategies in the rehabilitation of people with spinal cord injury.
1 CitationsSource
#1Erik J. Landaas (UW: University of Washington)H-Index: 1
#2Geoffrey S. Baird (UW: University of Washington)H-Index: 23
Last. Sean D. SullivanH-Index: 65
view all 5 authors...
OBJECTIVES: We designed, developed, and implemented a new hospital-based health technology assessment (HB-HTA) program called Smart Innovation. Smart Innovation is a decision framework that reviews and makes technology adoption decisions. Smart Innovation was meant to replace the fragmented and complex process of procurement and adoption decisions at our institution. Because use of new medical technologies accounts for approximately 50 percent of the growth in healthcare spending, hospitals and ...
Source
Source
#1Khanh Quoc Thai (Tokyo Metropolitan University)
#2Masayoshi Noguchi (Tokyo Metropolitan University)H-Index: 6
The English healthcare sector underwent extensive system reform over the period from 2010 to 2015, aimed principally at improving technical efficiency. This paper examines the effect of the reforms on foundation trusts in England with particular emphasis on technical efficiency. By employing data envelopment analysis (DEA) and a second-stage regression, we found evidence of an overall improvement in efficiency, notwithstanding some fluctuations. Specifically, we found that bed utilization had po...
Source
#1Anouck Kluytmans (Radboud University Nijmegen)H-Index: 5
#2Jaap Deinum (Radboud University Nijmegen)H-Index: 30
Last. Janneke P.C. Grutters (Radboud University Nijmegen)H-Index: 24
view all 8 authors...
: Background Choosing which biomarker tests to select for further research and development is not only a matter of diagnostic accuracy, but also of the clinical and monetary benefits downstream. Early health economic modeling provides tools to assess the potential effects of biomarker innovation and support decision-making. Methods We applied early health economic modeling to the case of diagnosing primary aldosteronism in patients with resistant hypertension. We simulated a cohort of patients u...
Source
#1Nader Jahanmehr (Shahid Beheshti University of Medical Sciences and Health Services)H-Index: 25
#2Atieh Sadat Bigdeli (Shahid Beheshti University of Medical Sciences and Health Services)
Last. Soheila Damiri (Shahid Beheshti University of Medical Sciences and Health Services)
view all 6 authors...
INTRODUCTION: Back pain is a common global disorder and magnetic resonance imaging (MRI) is one method of assessing its cause. The lack of official and general clinical guidelines is the cause of inadequate supervision of lumbar MRI prescriptions. The goal of this research was to analyze inappropriate lumbar MRI prescriptions and the resulting economic burden on individuals. METHOD: This is a descriptive-analytical study carried out on a sample of 614 patients who visited four hospitals in Tehra...
Source
#1Véronique Peiffer (Stanford University)H-Index: 1
#2Cynthia A. Yock (Stanford University)H-Index: 6
Last. Jan B. Pietzsch (Stanford University)H-Index: 14
view all 4 authors...
Source