Booth-Clibborn N, Packer C, Stevens A
University of Birmingham.
Int J Technol Assess Health Care. 2000 Summer;16(3):781-6. doi: 10.1017/s0266462300102053.
To analyze the rates and influences on the adoption of three selected health technologies: statins, coronary stents, and magnetic resonance imaging (MRI).
A retrospective diffusion study using primary care prescribing data and questionnaire responses from acute hospital trusts in the West Midlands region (population 5.3 million or 10% of England).
The selected technologies had markedly different diffusion curves. Statins diffused rapidly soon after launch. Coronary stents were initially used 6 years after first availability, but within 2 years all responding hospitals reported using them. MRI scanners were initially purchased 6 years after first availability with a subsequently slow rate of diffusion, and are still absent from some hospitals. Influences on the adoption of each technology were different. Commercial marketing was reported as a major influence on the diffusion of statins but not at all on MRIs. Cost impact was a major negative influence on the diffusion of MRI scanners and statins, whereas enthusiastic individuals were key to the diffusion of stents.
Influences on adoption and consequent diffusion rates are very different for different health technologies. It is not at all clear that such diffusion patterns relate well to an optimum timing rate. This has important implications for technology gatekeepers in health care.
分析三种选定医疗技术（他汀类药物、冠状动脉支架和磁共振成像（MRI））的采用率及其影响因素。
采用回顾性扩散研究，利用西米德兰兹地区（人口530万，占英格兰人口的10%）基层医疗处方数据和急性医院信托机构的问卷调查回复。
选定的技术具有明显不同的扩散曲线。他汀类药物上市后很快迅速扩散。冠状动脉支架在首次可用6年后开始使用，但在2年内所有回复的医院都报告使用了它们。MRI扫描仪在首次可用6年后开始采购，随后扩散速度缓慢，一些医院仍未配备。对每种技术采用的影响各不相同。商业营销被报告为他汀类药物扩散的主要影响因素，但对MRI扫描仪完全没有影响。成本影响是MRI扫描仪和他汀类药物扩散的主要负面影响因素，而积极热情的个人是支架扩散的关键因素。
不同医疗技术采用及其后续扩散速度的影响因素差异很大。目前尚不清楚这种扩散模式是否与最佳时间率密切相关。这对医疗保健领域的技术把关人具有重要意义。
