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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
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

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
Copyright
Copyright © Cambridge University Press 1995

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