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The Institute of Medicine was chartered in 1970 by the National Academy of Sciences to enlist distinguished members of the appropriate professions in the examination of policy matters pertaining to the health of the public. In this the Institute acts under both the Academy's 1863 congressional charter responsibility to be an advisor to the federal government and its own initiative in identifying issues of medical care, research, and education.

The Committee on Technological Innovation in Medicine was established in 1988 by the Institute of Medicine to design a series of workshops that would (a) provide a more fundamental knowledge of the process by which biomedical research findings are translated into clinical practice and (b) address opportunities for improving the rationality and efficiency of this process. This volume consists of the proceedings of the second workshop in the series “Improving the Translation of Research Findings into Clinical Practice: The Changing Economics of Technological Innovation in Medicine,” held December 20–21, 1989. This workshop and its proceedings were supported by the Howard Hughes Medical Institute and the Agency for Health Care Policy and Research of the Department of Health and Human Services (grant 5 RO9 HS055 26 02). The opinions and conclusions expressed here are those of the authors and do not necessarily represent the views of the Howard Hughes Medical Institute, the Department of Health and Human Services, the National Academy of Sciences, or any of their constituent parts.

Library of Congress Cataloging-in-Publication Data

The Changing economics of medical technology / Annetine C. Gelijns and Ethan A. Halm, editors ; Committee on Technological Innovation in Medicine, Institute of Medicine.

p. cm. — (Medical innovation at the crossroads ; v. 2)

Proceedings of a workshop held Dec. 20–21, 1989, supported by the Howard Hughes Medical Institute and the Agency for Health Care Policy and Research of the Dept. of Health and Human Services (grant 5 R09 HS055 26 02).

Includes bibliographical references and index.

ISBN 0-309-04491-X

1. Medical innovations—Economic aspects—Congresses. 2. Pharmaceutical industry—Technological innovations—Economic aspects—Congresses. I. Gelijns, Annetine. II. Halm, Ethan. III. Institute of Medicine (U.S.). Committee on Technological Innovation in Medicine. IV. Howard Hughes Medical Institute. V. United States. Agency for Health Care Policy and Research. VI. Series.

[DNLM: 1. Economics, Medical—congresses. 2. Public Policy—congresses. 3. Technology, High-Cost—economics—congresses. 4. Technology, Medical—economics—congresses. W1 ME342F v. 2 / W 74 C456 1989]

R855.2.C48 1991

338.43'61'028—dc20

DNLM/DLC

for Library of Congress

91-14157

CIP

Copyright © 1991 by the National Academy of Sciences

Printed in the United States of America

The serpent has been a symbol of long life, healing, and knowledge among almost all cultures and religions since the beginning of recorded history. The image adopted as a logotype by the Institute of Medicine is based on a relief carving from ancient Greece, now held at the Staatlichemuseen in Berlin.



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