Medical Technology — A Different View of the Contentious Debate over Costs

作者: Thomas W. Moloney , David E. Rogers

DOI: 10.1056/NEJM197912273012603

关键词: MarketingComputed tomographicUse of technologyPhysician reimbursementConvictionIncentiveClass (computer programming)Control (management)MedicineHealth technology

摘要: There is a growing conviction that medical technologies are major contributors to escalating costs, and regulating them generally viewed as the least contentious way control expenses in 1980's. Five forms of technology being discussed or developed. All aim reduce costs by controlling big, expensive class computed tomographic (CT) scanning. We present evidence such CT scanner account for far less growth expenditures than do collective thousands small tests procedures. Furthermore, we suggest each strategy large involves substantial practical conceptual problems would severely limit its effectiveness. thus shift away from attempts harness big technologies, toward incentives encourage more discerning use all technologies. To this end, propose changes physician reimbursement education expanded insurance physicians hospitals be selective technology.

参考文章(27)
Cooper S, Gaus Cr, Hirschman Cg, Contrasts in HMO and fee-for-service performance. Social Security Bulletin. ,vol. 39, pp. 3- 14 ,(1976)
Martin Feldstein, The rising cost of hospital care ,(1971)
George J. Schieber, Ira L. Burney, Judith B. Golden, William A. Knaus, Physician Fee Patterns under Medicare: A Descriptive Analysis New England Journal of Medicine. ,vol. 294, pp. 1089- 1093 ,(1976) , 10.1056/NEJM197605132942005
PAUL F. GRINER, Use of Laboratory Tests in a Teaching Hospital: Long-Term Trends Annals of Internal Medicine. ,vol. 90, pp. 243- 248 ,(1979) , 10.7326/0003-4819-90-2-243
Eugene Braunwald, Coronary-Artery Surgery at the Crossroads New England Journal of Medicine. ,vol. 297, pp. 661- 663 ,(1977) , 10.1056/NEJM197709222971209
J. Comroe, R. Dripps, Scientific basis for the support of biomedical science Science. ,vol. 192, pp. 105- 111 ,(1976) , 10.1126/SCIENCE.769161
Howard H. Hiatt, Protecting the Medical Commons: Who Is Responsible? New England Journal of Medicine. ,vol. 293, pp. 235- 241 ,(1975) , 10.1056/NEJM197507312930506
David E. Rogers, On Technologic Restraint Archives of Internal Medicine. ,vol. 135, pp. 1393- 1397 ,(1975) , 10.1001/ARCHINTE.1975.00330100119019