Assessing Medical Technologies (1985) / Chapter Skim
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7. Conclusions and Recommendations
7. Conclusions and Recommendations
Pages 244-254
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From page 244... ...
, or the Office of Medical Applications of Research (National Institutes of Health) mention a lack of cogent evidence on which to base secure conclusions.
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From page 245... ...
Diffusion of new methods is enhanced by the extent to which they are easy to use, require little effort to learn, impose little change in practice style, are highly remunerative and satisfying, and have no clinically worthy competitors. Also, some features of the setting in which physicians practice influence their use of medical technology; for example, physicians in group practices appear to adopt innovations more rapidly than physicians in solo practice.
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From page 246... ...
The extensive information needs for the assessment of medical technologies and the present lack of a central organization or agency make essential the creation of some systematic method for gathering information from multiple sources. In the committee's view, this monitoring function should extend beyond the United States to collect information from international efforts in medical technology assessment.
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From page 247... ...
Dissemination of Information Dissemination of information is a necessary component of any technology assessment system, because results must be promulgated both widely and through appropriate channels of communication if they are to influence patient care or provider reimbursement. The source of information or channel of communication can have varying degrees of influence on physician practice, as illustrated in Chapter 4.
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From page 248... ...
Manpower development and education of individuals should go beyond educating only those scientists charged with conducting technology assessment, because a broader community of individuals need ASSESSING MEDICAL TECHNOLOGY the results of these studies. They should be able to understand and take advantage of ongoing work; results should be diffused promptly and reliably to those who can act on the information.
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From page 249... ...
In its 1982 report, the OTA described various kinds of institutional arrangements (OTA, 1982~: (1) congressional sponsorship of a private-public body or chartering of an organization to undertake medical technology assessment activities, (2)
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From page 250... ...
Funding levels for the NCHSR A Separate Federal Agency have been falling steadily for a number of years, and current expenditures of approxi mately $14 million for technology assess ment primarily health services re search are meager in comparison with the tasks to be achieved. New legislation changes the name of NCHSR to the Na tional Center for Health Services Research and Health Care Technology Assessment (NCHSRHCTA)
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From page 251... ...
However, enormous barriers exist to establishing yet another independent federal agency, given pressures to decrease the number of or consolidate existing agencies. NOT THE REGULATORY APPROACH We notice that the fullest and most trustworthy health care technology assessment is to be found in the fields where regulatory authority and the profit motive are most operative: drugs and class III medical devices.
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From page 252... ...
Given the preponderance of money spent on health care and the comparatively vanishing amount spent on assessing medical technologies, the great need for primary data cited in many different studies and by different groups for making decisions about patient care, and the need to choose among technologies, the committee believes that the additional resources required to develop a coherent system should come from a larger share of the health care dollar. Various proposals have been made for tapping this dollar as outlined in Chapters 2 and 5, but further study is needed to map out exactly how to do this.
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From page 253... ...
The additional funds should be used to fill gaps in knowledge about technologies when the profit motive does not operate to catalyze the collection of primary data such as in the drug industry. · Those organizations that support research in technology assessment should engage in developing it as a scientific field, such as improving methodologies and supporting education and training of assessment personnel.
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From page 254... ...
1984. The cost of underutilization: Percutaneous transluminal angioplasty for peripheral vascular disease.
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