The Relationship between Health Policies, Medical Technology Trends and Outcomes: What Do We Know About Causality? (original) (raw)

Technological change in health care: Why are opinions so divided?

Managerial and Decision Economics, 1984

This paper purports to explain the widespread scepticism towards technological change in health care in general and pharmaceutical innovation in particular in the face of very high estimated rates of social return. These estimates are based on observable market prices and quantities, which are used for measuring the additional consumer surplus induced by an innovation. They grossly overstate true surplus due to the effect of insurance, however. For true demand for health care services and hence true surplus depends on the net price a patient is willing to pay, which is a rather small fraction of observed market price. The paper also outlines the conditions under which a health insurer would welcome a pharmaceutical innovation.

Role of Technology in Healthcare Policy

The term 'Medical Technology' is commonly used to refer to a variety of tools, machines, and processes that allow healthcare professionals to deliver health services that improve quality of life by early diagnoses, reduced complications, systematic treatments and/or reducing patient hospitalizations and invasive procedures.

Technology and health care-driving costs up, not down

IEEE Technology and Society Magazine, 1996

ealth care costs in the United States are approaching a trillion dollars per year, about 14% of the Gross National Product other major factors currently driving health care costs. Cost containment now seems to be the onlv [l]. Despite this enormous cost, an estimated 40 million people in the U.S., about 20% of the population, are without health insurance. An even greater number are only partially insured [Z], [3]. Under these circumstances, what are the roles of technical innovations such as telemedicine and electronic medical records? Will these innovations, if implemented, reduce health care costs, or just make the problem worse? In fact, such innovations are more likely to increase than to decrease costs. Moreover, the technical quality of the product is not as important as the motivations and skills of the users, and their goals in purchasing and using the technologies in question. In addition, in order to put this in a larger perspective, it is important to consider

Technology and expenditure growth in health care

2009

We examine the parallel trends in technology growth and cost growth in health care. A theoretical model of growth and productivity leads to a typology of medical technology: highly effective and inexpensive innovations (antibiotics, or aspirin and beta blockers for cardiac care), more expensive yet effective treatments for appropriate patients (hip and knee replacements, surgical interventions for heart attack patients), and "gray area" treatments with uncertain clinical value (ICU days among chronically ill patients). We show that the average productivity of treatments depend critically on the heterogeneity of effects across patients, the precise shape of the health production function, as well as the cost structure of procedures such as MRIs with high fixed costs and low marginal costs. Future productivity growth of the current system will be limited by constraints on health care financing because of high tax burdens and the collapse of private health insurance markets. Nonetheless, there are tremendous potential productivity gains from better coordination of care and information technology.

Adaption of New Technologies and Costs of Health Care

2006

The previous chapters have dealt with companies' responses to the contradictory government intentions of fostering innovation while seeking to hold down or reduce health care costs. This chapter shows how the interests of the stakeholders can be aligned by presenting a model which explains the links among technology pricing, efficiency of treatment, and long-term health care costs. These dimensions are contrasted with patient utilities received from acute and long-term care.

Technology Growth and Expenditure Growth in Health Care

2011

In the United States, health care technology has contributed to rising survival rates, yet health care spending relative to GDP has also grown more rapidly than in any other country. We develop a model of patient demand and supplier behavior to explain these parallel trends in technology growth and cost growth. We show that health care productivity depends on the heterogeneity of treatment effects across patients, the shape of the health production function, and the cost structure of procedures such as MRIs with high fixed costs and low marginal costs. The model implies a typology of medical technology productivity: (I) highly cost-effective "home run" innovations with little chance of overuse, such as anti-retroviral therapy for HIV, (II) treatments highly effective for some but not for all (e.g. stents), and (III) "gray area" treatments with uncertain clinical value such as ICU days among chronically ill patients. Not surprisingly, countries adopting Category I and effective Category II treatments gain the greatest health improvements, while countries adopting ineffective Category II and Category III treatments experience the most rapid cost growth. Ultimately, economic and political resistance in the U.S. to ever-rising tax rates will likely slow cost growth, with uncertain effects on technology growth.

Medical Technology and the Production of Health Care

This paper investigates the factors that determine differences across OECD countries in health outcomes, using data on life expectancy at age 65, over the period 1960 to 2007. We estimate a production function where life expectancy depends on health and social spending, lifestyle variables, and medical innovation. Our first set of regressions include a set of observed medical technologies by country. Our second set of regressions proxy technology using a spatial process. The paper also tests whether in the long-run countries tend to achieve similar levels of health outcomes. Our results show that health spending has a significant and mild effect on health outcomes, even after controlling for medical innovation. However, its short-run adjustments do not seem to have an impact on health care productivity. Spatial spill overs in life expectancy are significant and point to the existence of interdependence across countries in technology adoption. Furthermore, nations with initial low levels of life expectancy tend to catch up with those with longer-lived populations.

Anticipating and Assessing Health Care Technology

1987

The first report was addressed to an important purpose. The Commission reached the tentative conclusion early in its deliberations that a system for identifying future health care technology would be of limited benefit on its own. The Netherlands does not have an organized system for technology assessment in health care, and therefore information on the benefits, risks, financial costs, and social implications of technology is not available for new or established technology, generally speaking. The Commission saw the need for such a system. Studies aimed at the identification and assessment of future health care technologies must be developed within such a context, the Commission concluded. Therefore, Volume I was developed as an overall policy document, and contains only summary material on future technologies. This Volume gives the detailed information on the same technologies and technological areas. This report on future health care technology is based on information obtained from surveys done in the United States and in Europe. The first survey was carried out by the Office of Technology Assessment (OTA) of the U.S. Congress in late 1984, in cooperation with the STG. The analysis of the information obtained was carried out by Mr. Clyde Behney, on loan from OTA. The Commission is very grateful to OTA and to Mr. Behney for this invaluable assistance. While this report was written by the project staff as a team effort, Mr. Jan Griffioen had the special responsibility for translating the Dutch responses to English, analyzing them, and entering them in the appropriate computer file that formed the basis for this report. Technological developments in health care are occurring rapidly, and the information in this report will rapidly become out-of-date. The Commission is aware of this fact, and hopes that it will be possible to continue an 'early warning system' that will periodically update such information. This report is primarily addressed to policy makers and to those who are interested in national level policy making. At the same time, the Commission believes that the information in this report is an important basis for future activities in health care technology assessment in Netherlands and in other countries.