THE PHYSICIAN'S STAKE IN MEDICAL ECONOMICS.
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The paper considers the economic characteristics of technology and suggests a categorization based on the economic nature of particular technologies and their effect on the product health care that may be helpful in considering the economics of technology in hospitals. It reviews the range of economic forces that might be expected to apply to the use of technology in the hospital setting, and notes some of the evidence to support such hypotheses. In considering the limited evidence from the United Kingdom and elsewhere in Europe, the paper contrasts its focus on socio-political, institutional, and organizational factors, rather than the direct economic factors considered in the United States work. It suggests that the multiplicity of forces at work make cross-national, empirical, and policy analyses very difficult. Indeed, without more economic appraisal the effect of differences in technology adoption cannot be evaluated.
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To determine the economic impact of acquired immunodeficiency syndrome (AIDS) or AIDS-related complex (ARC) cases on North Carolina hospitals, we collected inpatient data from all North Carolina hospitals on charges and number of patients discharged with these diagnoses. More than 97% of the state's hospitals responded to the survey for the study year (1987-1988). There were 540 AIDS/ARC discharges from 58 North Carolina general hospitals and 125 AIDS/ARC discharges from 13 other types of hospitals, for a statewide total of 665 patients. The total general hospital charges for AIDS/ARC inpatients in North Carolina were approximately $7.7 million per year, and almost $2 million of these charges were uncompensated by any insurance. The greatest burden of cost for this care was borne disproportionately by 15 of the 58 general hospitals, accounting for 82% of the discharges.
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