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Biomedical subjects

N A Hirsch

Publications and source records attributed to N A Hirsch.

4 recordsLinked to original sources
PubMed1993

Diffusion of new technologies to treat renal stones in Australia.

Several new therapies for treating renal stones developed since the 1980s have considerably reduced the use of open surgery and endoscopy for this condition. Extracorporeal shock wave lithotripsy (ESWL) has made the biggest impact. Assessment of ESWL in the early stages of its development assisted in rational introduction of the technology in Australia. However, this effect was short-lived and Australia would now appear to have a significant overcapacity in this technology. Use of ESWL in recent years indicates that distance is a major factor in reducing access to this technology. These observations raise several issues that need addressing, including the limited ability to avoid inappropriate proliferation of a technology, uneven distribution of ESWL units, difficulties of access and the effects of overcapacity upon indications and upon the cost-effectiveness of a technology.

Australia↗
PubMed1993

Influences on the introduction and use of minimally invasive therapies in Australia.

Minimally invasive therapies (MIT), developed as alternatives to open surgery, offer the promise of reduction in morbidity and mortality, quicker return of patients to their normal activities and lower overall costs to society. However, minimally invasive therapies cause concern in that their comparative advantage over older methods may not always be well defined, their introduction may result in additional costs and reorganization for the institutions where they are used, and achieving adequate training of all who use them may not be easy. In this paper, the Australian experience in the introduction and assessment of some MIT is considered to illustrate a number of the issues facing those who use and fund such methods. Examples include both high capital cost technologies, such as shock wave lithotripsy and stereotactic radiosurgery, and less expensive techniques such as laparoscopic surgery.

Ambulatory Surgical Procedures↗
PubMed1992

Laparoscopic cholecystectomy.

Laparoscopic cholecystectomy is rapidly diffusing throughout Australia. Its advantages are low morbidity, fast recovery and lower overall costs compared with open cholecystectomy. However several issues need to be addressed in relation to this procedure such as adequate training, use of disposable instruments, suitability as an outpatient treatment, and cost and payment questions.

Australia↗