Centre for Research on Health and Social Care Management (CERGAS), Università Bocconi, Via Roentgen, Milan, Italy.
Health Policy. 2011 Apr;100(1):51-9. doi: 10.1016/j.healthpol.2010.10.004. Epub 2010 Nov 4.
In the last decade the pace of innovation in medical technology has accelerated: hence the need to better identify and understand the real forces behind the adoption and diffusion of medical technology innovations in clinical practice. Among these forces, financial incentives may be expected to play a major role. The purpose of this paper was to assess the influence of financing mechanisms for new medical devices and correlated procedures on their diffusion. The analysis was carried out in the Italian inpatient cardiovascular area and applied to drug eluting stents over the period 2003-07. The paper's main hypothesis, that higher levels of reimbursement encourage technology diffusion, was rejected. So was the hypothesis that private hospitals may be more sensitive to tariff levels than public hospitals. A statistically significant difference was found only between hospitals that are funded on a Diagnosis-Related Groups (DRGs) basis and those that are not, with the former showing higher levels of technology diffusion. These results warn policy makers against excessive reliance on specific reimbursement fee changes as a way of steering provider behaviour.
在过去的十年中，医疗技术的创新步伐加快了：因此，有必要更好地识别和理解在临床实践中采用和推广医疗技术创新的真正力量。在这些力量中，经济激励措施可能会发挥重要作用。本文旨在评估新医疗器械和相关程序的融资机制对其扩散的影响。该分析在意大利住院心血管领域进行，并应用于 2003-07 年期间的药物洗脱支架。本文的主要假设，即更高的报销水平鼓励技术扩散，被拒绝了。私人医院对费率水平的敏感度可能高于公立医院的假设也被拒绝了。只有在基于诊断相关组（DRGs）的资金医院和非资金医院之间发现了统计学上的显著差异，前者显示出更高水平的技术扩散。这些结果告诫政策制定者不要过分依赖特定的报销费用变化作为引导提供者行为的一种方式。
