Adopting New Medical Technology (1994) / Chapter Skim
Currently Skimming:
4. ROLE OF THE HOSPITAL IN THE ACQUISITION OF TECHNOLOGY
4. ROLE OF THE HOSPITAL IN THE ACQUISITION OF TECHNOLOGY
Pages 61-70
The Chapter Skim interface presents what we've algorithmically identified as the most significant single chunk of text within every page in the chapter.
Select key terms on the right to highlight them within pages of the chapter.
From page 61... ...
In addition, hospitals are the sites for many clinical trials of drugs and devices and for the clinical training of most physicians. In this chapter we discuss how recent public policy decisions have provided hospital managers greater incentives to conduct technology assessments.
|
From page 62... ...
Recent changes, however, have provided hospital managers with a stronger incentive to become involved in both medical practice evaluation and technology assessment. The change from cost- and charge-based reimbursement to prospective payment has changed technology-intensive departments, such as radiology, from being "profit centers" to being "cost centers." In addition, with the inclusion of capital expenditures under the Medicare prospective payment system, hospital managers have become more concerned about their capital budgets, since hospitals can no longer pass higher capital costs on to the Medicare program.
|
From page 63... ...
Thus, although a number of new forces that increase hospitals' incentives to perform technology assessments and monitor medical practices have emerged over the past decade, other incentives cut against these new forces. As a result, it is unclear how extensively hospital managers have actually altered their behaviors.
|
From page 64... ...
In making technology acquisition and utilization decisions, they consider the need to improve existing clinical strengths, provide synergy with existing technologies, be consistent with the hospital's overall mission, minimize financial risk, and recognize the life span of a product. According to a survey of 524 health care managers in 1990, the following criteria were rated as "very important" by more than half of them: the ability to establish or expand services (85 percent)
|
From page 65... ...
If more technology assessments are to be conducted from the hospital's perspective, it is important to examine the potential implications of changing the assessment perspective from what benefits society generally to what benefits a specific hospital. In discussing these potential implications, our intention is not to imply that hospital managers do not consider society in making their decisions; rather, our objective is to point out how adoption of the hospital's perspective might affect technological assessment and diffusion at the margin.
|
From page 66... ...
In addition, they will be less concerned about technologies that prevent readmissions, because under most payment systems readmissions offer the hospital an opportunity for a second payment. The hospital perspective thus could increase long-term health care costs as hospital managers focus on short-term cost implications.
|
From page 67... ...
Although individual hospitals are unlikely to devote considerable resources to any single assessment, the effect of many hospitals performing assessments on the same technology could result in more total resources being devoted to technology assessment. In view of the cost of performing technology assessments, hospital managers are forming technology assessment consortia.
|
From page 68... ...
Few hospitals deferred acquisition decisions until a technology was mature and an assessment of it had been performed from a societal perspective. Although several changes in regulatory, legal, and payment policies that increase hospital managers' incentives to perform technology assessments have been implemented over the past decade, we believe hospitals continue to be early adopters of new technologies, largely because several forces promoting the early adoption of technology counterbalance the incentives to perform careful technology assessments.
|
From page 69... ...
We believe that technology assessment conducted from a hospital perspective instead of a societal perspective promotes the more rapid diffusion of medical technology, gives less weight to long-term outcomes and long-run health care costs, and increases the overall cost of conducting technology assessments. Public policy could mitigate some of these effects by establishing payment systems that emphasize total health care costs and information systems that emphasize the longer-term impacts of different treatment modalities.
|
From page 70... ...
1992. Beyond technology assessment: Balancing needs, strategy.
|
Key Terms
This material may be derived from roughly machine-read images, and so is provided only to facilitate research.
More
information on Chapter Skim is available.