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PubMed1994

New imaging technology and cost containment.

New diagnostic imaging technologies have borne unusual scrutiny in considerations of health care cost containment. This scrutiny derives from a history of relatively poor technologic assessment, questions about the extent to which technologic innovations promulgate improvements in patients' health, and observations that economic concerns often take precedence over medical ones in technology acquisition decisions. Current and future legislative and market-driven health care reform initiatives will require providers thinking of acquiring new imaging technologies to assess their costs and benefits more rigorously.

Cost Control↗
PubMed1994

Technology assessment: scientific challenges.

Because of rising health care costs, radiologists will increasingly be asked to provide scientific evidence to justify the use of diagnostic imaging. In the past, information about the diagnostic accuracy of imaging tests was sufficient; in the future, information about the impact of diagnostic imaging on patients' outcomes will be needed. In this article, some of the important aspects of technology assessment are discussed. All radiologists should become familiar with these concepts. The strengths as well as the limitations of different approaches must be appreciated in order for us to achieve our goal of providing the best care that we can for our patients.

Cost Control↗
PubMed1990

The economics of high-technology medical imaging.

The field of high-technology medical imaging equipment and methods have recently received undue negative attention in the battle against sharply increasing health-care costs. This article identifies numerous imaging methods and examines the field's vulnerable areas such as high capital equipment costs and subsequent high operating costs. Comparison is drawn between the cost of high-tech medical imaging and the total cost of health care. The multiple benefits of medical imaging to the practice of medicine in relation to its total cost are also discussed. Evidence is presented to support the view of Dr. D. MacEwan, former president of the Radiological Society of North America: "High-technology imaging devices do not have to increase the cost of health care and can actually save money if passed judiciously." This conclusion was reached from a 13-year study examining the health-care records of more than one million Manitobans.

Canada↗
PubMed1990

Hospitals changing their buying habits. Overhauled technology-acquisition processes help equip facilities to make prudent purchases.

As hospitals face increasing pressure to rein in costs, equipment spending faces stiff competition for limited funds. When facilities replace aging or outdated equipment, they're often replacing the entire technology assessment process as well. One hospital facing a $4 million bill to equip a new building is revamping its purchasing process based on department "wish lists." And an Ohio system has formed a special division to speed assessment and implementation of new technologies and procedures.

Arkansas↗
PubMed1994

Technology assessment and transfer in district health systems.

Initially reviewing the concepts of a district health system and technologies, the article develops into a discussion on health technologies and the process of their transnational diffusion, as well as their impact on district health systems in developing countries. Finally, the paper points to the need for assessment and quality assurance in a managed transfer of technologies.

Developing Countries↗
PubMed1991

Biliary lithotripsy versus cholecystectomy: a cost-utility analysis.

Evaluating the economic impact of medical procedures is of increasing importance in the American health care system, and this is especially true in the case of new medical technologies. Both the cost and the outcome of a treatment, and its alternatives must be evaluated. A cost-utility analysis was performed to compare cholecystectomy with biliary lithotripsy accompanied by bile acid therapy. Using a Markov approach, a model was designed to project expected cost and quality-adjusted survival over a 5-year period in patients with solitary stones of less than or equal to 20 mm in diameter. The viewpoint of the analysis was chosen to be that of the general society, since it can be considered as a consensus of all interest groups. Direct costs were obtained from hospitals in Atlanta, Georgia; indirect costs are based on average United States earnings. Utility was estimated using a model that combines different scales of well-being with an underlying etiology. The findings indicate that from society's point of view for all patients meeting lithotripsy inclusion criteria, based on this cost-utility analysis, biliary lithotripsy would be the procedure of choice.

Adult↗