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Biomedical subjects

H D Banta

Publications and source records attributed to H D Banta.

85 records · Page 5Linked to original sources
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Future health care technology and the hospital.

The past decades have been a time of rapid technological change in health care, but technological change will probably accelerate during the next decade or so. This will bring problems, but it will also present certain opportunities. In particular, the health care system is faced with the need to spend its limited resources more effectively. The number of hospital beds is being reduced, and lengths of stay are falling. In the future, the health care system will have to care for an increasing number of elderly people, both with chronic disease and also with dependency because of frailty and functional problems. The hospital of the future will probably be smaller and more intensive in the nature of its care. In part, this is because many present and future clinical technologies can be delivered outside of the hospital setting. And communication technologies offer the possibility of tying the various parts of the health care system into one true system. This would mean that the future hospital would have a more active role in supervising technical care outside of the hospital, and in making specialized knowledge accessible in all parts of the health system.

Computer Systems↗
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Health care technology as a policy issue.

Health care technology has become an increasingly visible issue in many countries, primarily because of the rising costs of health care. In addition, many questions concerning quality of care are being raised. Health care technology assessment has been seen as an aid in addressing questions concerning technology, including benefits and costs. A number of industrialized countries have developed active programs of health care technology assessment during the past two decades. Eight countries at similar levels of socio-economic and health development--Australia, Canada, France, Germany, the Netherlands, Sweden, the United Kingdom and the United States--have been examined to gain insights into how they manage health care technology and what place technology assessment has in such management. In addition to seeking general information, specific cases--treatment for coronary artery disease, medical imaging, laparoscopic surgery, treatment of end-stage renal disease, neonatal intensive care, and breast cancer screening--were examined in each country.

Australia↗
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Health care technology in Sweden.

Health care in Sweden is a public sector responsibility and equity in access to care is quite important. The Swedish system is organized into several levels, with the Federation of County Councils at the top, and with regional, county, and local levels. In theory, the four hospital tiers developed by these different levels provide a clear hierarchy for acquisition of sophisticated new technologies. In practice, certain problems have emerged, especially rigidity of the system. Reforms are underway. Sweden was one of the first countries to become involved in the assessment of health care technology. From the beginning, technologies were assessed to determine if they were 'consistent with proven scientific knowledge and good experience'. Sweden has a national program in health care technology assessment (TA), and TA is increasingly visible to policy makers and physicians. Health care TA has been effectively institutionalized in Sweden and has a bright future. The greatest problem in the Swedish context is the large number of unassessed technologies. Because of this, international cooperation is essential.

Delivery of Health Care↗
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Lessons from the eight countries.

While the eight countries presented in this issue differ considerably from each other, they have important similarities. All have faced the problem of increasing health care expenditures, and all are coming to recognize problems with health care technology such as inappropriate use and poor quality of care. Health reforms appear to be accelerating in the countries examined. In addition, all countries now have stated policy goals of assessing the benefits of health care technologies and most have established formal programs for health care technology assessment. Technology assessments impact varies, but it is becoming an important factor in technology acquisition. These trends point to a future for technology assessment and perhaps to better management of health care technology. International cooperation is important if this goal is to be realized.

Australia↗
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Health activities of the U.S. Office of Technology Assessment.

The Office of Technology Assessment (OTA) was formed as part of the US Congress of 1972. The 'Health Program' was established in 1975. The purpose of the OTA is to advise Congress on the positive and negative implications of technological change. Since its beginning, the Health Program has spent most of its effort in describing technology assessment in health care and federal policies toward such assessment. A number of specific medical technologies have also been evaluated. Reports on health-care topics by the OTA have had some specific effects in Congress, but the more important impact is probably on the broader climate of opinion concerning medical technology and its benefits, risks, and costs. Technology assessment has become an established part of the Congressional decision-making process and is being used increasingly in countries other than the United States.

Government Agencies↗