Department of Medicine at Beth Israel Deaconess Medical Center in Boston, Massachusetts, USA.
Health Aff (Millwood). 2009 Nov-Dec;28(6):w1122-32. doi: 10.1377/hlthaff.28.6.w1122. Epub 2009 Oct 14.
Technology is a major driver of health care costs. Hospitals are rapidly acquiring one new technology in particular: 64-slice computed tomography (CT), which can be used to image coronary arteries in search of blockages. We propose that it is more likely to be adopted by hospitals that treat cardiac patients, function in competitive markets, are reimbursed for the procedure, and have favorable operating margins. We find that early adoption is related to cardiac patient volume but also to operating margins. The paucity of evidence informing this technology's role in cardiac care suggests that its adoption by cardiac-oriented hospitals is premature. Further, adoption motivated by operating margins reinforces concerns about haphazard technology acquisition.
技术是医疗保健成本的主要驱动因素。医院正在迅速采用一种新技术:64 层计算机断层扫描(CT),可用于对冠状动脉进行成像以寻找阻塞物。我们认为,在治疗心脏病患者、在竞争激烈的市场中运作、获得该程序报销并有良好运营利润的医院更有可能采用这种技术。我们发现,早期采用与心脏病患者数量有关,但也与运营利润有关。缺乏证据表明该技术在心脏护理中的作用,这表明面向心脏的医院采用该技术还为时过早。此外,受运营利润驱动的采用加剧了对随意获取技术的担忧。