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PubMed2000

Understanding health technology assessment.

To make the best use of scarce national health-care resources the adoption and diffusion of new technologies is now linked to evidence of their cost- as well as clinical effectiveness. Thus, the goal of medical device manufacturers today must be to provide value for money. This article details the process of conducting this assessment.

Cost-Benefit Analysis↗
PubMed2000

Physician-assisted suicide in the United States: the underlying factors in technology, health care and palliative medicine--Part one.

In an age of rapid advances in life-prolonging treatment, patients and caregivers are increasingly facing tensions in making end-of-life decisions. An examination of the history of health care in the United States reveals technological, economic, and medical factors that have contributed to the problems of terminal care and consequently to the movement of assisted suicide. The movement has its roots in at least two fundamental perceptions and expectations. In the age of technological medicine energized by the profit motive, dying comes at a high price in suffering and in personal economic loss. The failure to provide affordable resources for terminal care is the result of the marketplace in health care. The medical profession has been painfully slow in responding to the challenges of terminal care, mainly because of the pressures of the marketplace and lack of adequate training. This has occurred at a time of rapid advances in life-sustaining treatment and of expanding public awareness of personal rights under the law. Overly aggressive treatment in the final stages of terminal illness has enhanced anxieties over a painfully prolonged and expensive dying. These factors have promoted the movement to assisted suicide. In the U.S. debate of the issues, ethicists tend to argue abstractly without examining adequately the context of terminal care that is the health care system. It is a system in dire need of a reform that will remove it from the marketplace.

Health Care Costs↗
PubMed1991

Big ticket health technology: is rational utilization possible?

Medical technologies that have high initial and operating costs are commonly labeled 'Big Ticket Technologies'. However, technologies with lower initial and operating costs, but which are utilized extensively in patient care, should be considered Big Ticket as well. Some of these technologies are product innovations, because they represent a new product or service. Others are process innovations because they provide an alternative way of delivering health care. Radiology and radiation oncology offer many examples of Big Ticket technologies in medicine, including CT scanners, MRI units and linear accelerators. Other examples include extracorporeal shock wave lithotripsy and resuscitation and intensive care technologies. Differences in the availability of these technologies in various countries reflects financial incentives and disincentives at work in the countries, expectation levels for health care in the countries, and the degree to which the diffusion and use of medical technologies are regulated. Evidence of the cost-effectiveness of medical technologies, and the impact of their use on health outcomes, is rapidly being added as an additional criterion for evaluation of the usefulness of medical technologies in health care.

Cost-Benefit Analysis↗
PubMed1994

Assessing utilisation of health technologies: coronary artery bypass graft surgery in New South Wales.

The New South Wales health system aims to provide the most effective and efficient health care in a context of scarce resources and increasing availability of expensive technologies. The aging of the population and the management of chronic disease place further demands on the health system. Examination of the pattern of provision of services over time and between groups can serve to illustrate trends in clinical management practices which may affect other elements of the health system. In this paper we report an evaluation of the patterns of coronary artery bypass graft surgery (CABG) in New South Wales, within subgroups of the population and over time. The results demonstrate increased utilisation of this procedure in the population over recent years, particularly among the older age groups. We found differences in procedure rates between geographic areas which suggest that there are differences in the management of ischaemic heart disease between population subgroups. These patterns are examined in the context of the available literature on the health outcomes of CABG relative to other management options for ischaemic heart disease.

Adult↗
PubMedDate not supplied

[Medical technology and health. A lot of crunching but few nuts?].

The present work pretend to describe the development achieved in the field of health technology assessment and to propose a set of criteria to evaluate them, with the intention that it will lead to the development of health programs and policy with a tendency to maximize effectiveness, efficiency and quality, within a frame of increasing needs and scarce technical and economic resources for health care. For this work, a comprehensive review was carried out about the background of health technology adoption in our country, and the context by which to evaluate the accessibility and utilization of the health technology. In the section for technology assessment, it is propose a method to evaluate based upon the natural history of disease, that is, the traditional form of health assessment is restricted to a cross section in time (vertical evaluation), and in this study the authors propose a model with a horizontal approach, that should offer as its main virtues the development of guidelines with regards to prevention, diagnosis and treatment, in addition to cost containment, in support to a more effective and higher quality medical practice.

Developing Countries↗
PubMedDate not supplied

New trends in high-technology health care support services.

To understand clearly the economic dynamics of high-technology service and support in hospitals, the author used results of recent studies carried out by D. F. Blumberg & Associates, utilizing a variety of sources, to identify existing cost components of the typical 300- to 400-bed general hospital located in a major metropolitan area in the United States. The largest single functional component of cost is direct labor and benefits. Other major cost items include direct overhead administration and infrastructure costs and outside material equipment and supply purchases. This evaluation, based on extensive benchmarking comparison and market estimates, suggests that the issues of make, buy, or outsource are neither trivial nor easy to resolve in the health care field.

Benchmarking↗