Hostname: page-component-78c5997874-8bhkd Total loading time: 0 Render date: 2024-11-16T05:05:38.085Z Has data issue: false hasContentIssue false
  • English
  • Français

Economic Forces and Hospital Technology

Lessons from the United States Experience

Published online by Cambridge University Press:  10 March 2009

John H. Goddeeris
John H. Goddeeris
Affiliation:
Michigan State University
Get access Rights & Permissions [Opens in a new window]

Abstract

This paper considers economic forces on the organization and use of technology in hospitals from a U.S. perspective. U.S. hospitals are moving from a period of very loose financial constraints to one in which the demand side of the market is likely to exert much greater discipline. Theory and limited evidence suggest some important effects on the adoption and use of technology, leading in general to more emphasis on cost reduction and less emphasis on costly quality improvements. Also discussed are economic influences on the movement of technology out of the hospital and on the development of new technologies. Finally, some peculiarities of very high cost technologies are noted.

Type
Special Section: The Organization and Use of Technology in the Hospital Part I: Social, Economic, and Political Issues
Information
International Journal of Technology Assessment in Health Care , Volume 3 , Issue 2 , April 1987 , pp. 223 - 240
Copyright
Copyright © Cambridge University Press 1987

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Aaron, H. J., & Schwartz, W. B.The painful prescription: Rationing hospital care. Washington, DC: Brookings Institute, 1984.Google Scholar
2.American Hospital Association. Hospital statistics, 1985 Edition. Chicago: AHA, 1985.Google Scholar
3.American Hospital Association. Economic Trends. Chicago, AHA, 1986, 2.Google Scholar
4.American Medical Association. Socioeconomic aspects of medical practice, 1985. Chicago: AMA, 1985.Google Scholar
5.Arnett, R. H., Cowell, C. W., Davidoff, L. M., & Freeland, M. S.Health spending trends in the 1980s: Adjusting to financial incentives. Health Care Financing Review, Spring 1985, 6, 1–26.Google Scholar
6.Arrow, K. Economic welfare and the allocation of resources to invention. In Essays in the Theory of Risk-Bearing. Amsterdam: North Holland, 1970.Google Scholar
7.Ayres, S. M.Magnitude of use and costs of in-hospital respiratory therapy, American Review of Respiratory Disease, 11 1980, part 2, 122, 11–13.CrossRefGoogle ScholarPubMed
8.Braun, S. R., et al. Evaluating the changing role of respiratory therapy services at two hospitals. Journal of the American Medical Association, 1981, 245, 2033–37.CrossRefGoogle ScholarPubMed
9.Celis, W.Hospitals compete for affluent patients by offering luxury suites and hot tubs. Wall Street Journal, 02 3, 1986.Google Scholar
10.Coelen, C., & Sullivan, D.An analysis of the effects of prospective reimbursement programs on hospital expenditures. Health Care Financing Review, Winter 1981, 3, 1–40.Google Scholar
11.Cromwell, J., & Kanak, J.The effects of prospective reimbursement programs on hospital adoption and service sharing. Health Care Financing Review, 12 1982, 4, 67–88.Google ScholarPubMed
12.Economic report of the President. Washington, DC: GPO, 1985.Google Scholar
13.Ellwood, P., & Paul, B.But what about quality. Health Affairs, Spring 1986, 5, 135–40.CrossRefGoogle ScholarPubMed
14.Enthoven, A.Health Plan. Reading, MA: Addison-Wesley, 1980.Google Scholar
15.Feldstein, M.Quality change and the demand for hospital care. Econometrica, 1977, 45, 1681–1702.CrossRefGoogle Scholar
16.Feldstein, M.Hospital cost inflation: A study of nonprofit price dynamics. American Economic Review, 1971, 61, 853–72.Google Scholar
17.Feldstein, M., Taylor, A.The Rapid Rise of Hospital Costs. Washington, DC: GPO, 1977.Google Scholar
18.Feldstein, P. J.Health care economics, 2nd ed., New York: Wiley, 1983.Google Scholar
19.Gelman, D., et al. Staying home, feeling better. Newsweek, 07 7, 1986.Google ScholarPubMed
20.Gibbard, A.The prospective pareto principle and equity of access to health care. Milbank Memorial Fund Quarterly, 1982, 60, 399–428.CrossRefGoogle ScholarPubMed
21.Goddeeris, J. H.Insurance and incentives for innovation in medical care. Southern Economic Journal, 1984, 51, 530–39.CrossRefGoogle Scholar
22.Goddeeris, J. H., & Weisbrod, B. A.What we don't know about why health expenditures have soared: Interaction of insurance and technology. Mt. Sinai Journal of Medicine, 1985, 52, 685–91.Google ScholarPubMed
23.Health Insurance Institute. Sourcebook of health insurance data. 1984–85. Washington, DC: HII, 1985.Google Scholar
24.Interstudy. National HMO census. Excelsior, MN: Interstudy, 1984.Google Scholar
25.Joskow, P.Controlling hospital costs: The role of government regulation. Cambridge, MA: MIT Press, 1981.Google Scholar
26.Levit, K. R., Lazenby, H., Waldo, D. R., & Davidoff, L. M.National health expenditures, 1984. Health Care Financing Review, Fall 1985, 7, 1–35.Google ScholarPubMed
27.Luft, H. S.Health maintenance organizations, New York: Wiley, 1981.Google Scholar
28.Manning, W. G., et al. A controlled trial of the effect of a prepaid group practice on use of services. New England Journal of Medicine, 1984, 310, 1505–10.CrossRefGoogle ScholarPubMed
29.Newhouse, J., et al. Some interim results from a controlled trial of cost sharing in health insurance. New England Journal of Medicine, 1981, 305, 1501–07.CrossRefGoogle ScholarPubMed
30.Rice, T., de Lissovoy, G., Gabel, J., & Ermann, D.The state of PPOS: A national survey. Health Affairs, Winter 1985, 4, 25–40.CrossRefGoogle ScholarPubMed
31.Romeo, A., Wagner, J., & Lee, R.Prospective reimbursement and the diffusion of new technologies in hospitals. Journal of Health Economics, 1984, 3, 1–24.CrossRefGoogle ScholarPubMed
32.Russell, L. B.Technology in hospitals. Washington, DC: Brookings Institute, 1979.CrossRefGoogle Scholar
33.Salkever, D., & Bice, T.The impact of Certificate of Need controls on hospital investment. Milbank Memorial Fund Quarterly, 1976, 54, 185–214.CrossRefGoogle ScholarPubMed
34.Scherer, F. M.Industrial market structure and economic performance, 2nd ed., Boston: Houghton Mifflin, 1980.Google Scholar
35.Schorr, B., & Chase, M.Some states, trying to curb Medicaid costs, alter way medical care is provided to the poor. Wall Street Journal, 03 4, 1985.Google Scholar
36.Sloan, F.Rate regulation as a strategy for hospital cost control: Evidence from the last decade. Milbank Memorial Fund Quarterly, 1983, 61, 195–221.CrossRefGoogle ScholarPubMed
37.Sloan, F., Valvona, J., Perrin, J. M., & Adamache, K. W.Diffusion of surgical technology: An exploratory study. Journal of Health Economics, 1986, 5, 31–61.CrossRefGoogle ScholarPubMed
38.U.S. Congress, Office of Technology Assessment. Medicare's prospective payment system. Washington, DC: GPO, 1985.Google Scholar
39.U.S. Congress, Office of Technology Assessment. Federal policies and the medical devices industry, Washington, DC: GPO, 1984.Google Scholar
40.U.S. Congress, Office of Technology Assessment. Medical technology and costs of the Medicare program. Washington, DC: GPO, 1984.Google Scholar