06476nam 2200817Ia 450 991096559960332120251116140711.09786610211210978128021121812802112109780309586412030958641097805850017530585001758(CKB)110986584751410(EBL)3376266(SSID)ssj0000097486(PQKBManifestationID)11121536(PQKBTitleCode)TC0000097486(PQKBWorkID)10119344(PQKB)10625916(MiAaPQ)EBC3376266(Au-PeEL)EBL3376266(CaPaEBR)ebr10055317(CaONFJC)MIL21121(OCoLC)923262428(Perlego)4738793(BIP)13279(EXLCZ)9911098658475141019940302d1994 uy 0engur|n|---|||||txtccrAdopting new medical technology /Annetine C. Gelijns and Holly V. Dawkins, editors ; Committee on Technological Innovation in Medicine, Institute of Medicine1st ed.Washington, D.C. National Academy Press19941 online resource (240 p.)Medical innovation at the crossroads ;v. 4"Proceedings of the fourth workshop in the series 'Examining coverage and adoption decisions about medical technologies,' held in Washington, D.C., on September 18-19, 1992"--T.p. verso.9780309050357 0309050359 Includes bibliographical references and index.""Adopting New Medical Technology""; ""Copyright""; ""Acknowledgments""; ""Contents""; ""PART I Setting the Stage""; ""1 Introduction ""; ""REFERENCES""; ""2 The Nature of Technological Change: Incentives Matter! ""; ""INTRODUCTION""; ""A BRIEF RECENT HISTORY OF HEALTH CARE IN THE UNITED STATES: TECHNOLOGICAL CHANGE AND THE GROWTH OF...""; ""DEFINING ""HEALTH CARE""""; ""EFFECTS OF RESEARCH AND DEVELOPMENT (TECHNOLOGICAL CHANGE) ON THE HEALTH CARE INSURANCE SYSTEM""; ""EFFECTS OF THE INSURANCE/FINANCE SYSTEM ON RESEARCH AND DEVELOPMENT""""EFFECTS OF INSURANCE ON CHOICE OF TECHNOLOGY AND QUALITY OF HEALTH CARE IN THE SHORT RUN, WITH TECHN...""""CONCLUDING REMARKS""; ""REFERENCES""; ""3 The Impact of Technology Assessment on Decisions by Health Care Providers and Payers ""; ""OBJECTIVE""; ""METHODOLOGY""; ""RESULTS""; ""DISCUSSION""; ""Quality Issues""; ""Individual Skill Levels in Technology Assessment Vary Widely""; ""Technology Assessment Research is Expensive""; ""Timely Technology Assessment Information is Scarce""; ""Scope Issues""; ""Future Issues""; ""Education""; ""Financial Support""; ""Information""; ""REFERENCES""""PART II Provider Decisionmaking """"4 Role of the Hospital in the Acquisition of Technology ""; ""THE CHANGING FINANCIAL ENVIRONMENT""; ""MODELS OF HOSPITAL BEHAVIOR""; ""TECHNOLOGY ASSESSMENT: SOCIETAL VERSUS HOSPITAL PERSPECTIVE""; ""Societal Versus Hospital Perspective: Some Examples""; ""POLICY CONSIDERATIONS""; ""CONCLUSION""; ""REFERENCES""; ""5 Physicians' Decisions Regarding the Acquisition of Technology ""; ""INCENTIVES FOR THE ADOPTION OF MEDICAL INNOVATIONS""; ""CONCEPTUAL MODEL""; ""Innovation Characteristics""; ""Provider Characteristics""; ""Knowledge""; ""Awareness""""Judgment""""Trial""; ""Adoption""; ""Evaluation""; ""SUMMARY""; ""REFERENCES""; ""PART III Third Party Payer Coverage Decisions""; ""6 Decisionmaking in the Health Care Financing Administration ""; ""BACKGROUND ON MEDICARE COVERAGE""; ""PROBLEMS WITH THIS APPROACH""; ""PAYMENT CHANGES""; ""TOWARD A MORE REASONABLE COVERAGE APPROACH""; ""CONCLUSION""; ""REFERENCES""; ""7 Blue Cross and Blue Shield Association Initiatives in Technology Assessment ""; ""TECHNOLOGY ASSESSMENT""; ""Recent Changes to Program""; ""THE DEMONSTRATION PROJECT ON BREAST CANCER TREATMENT""; ""FUTURE DIRECTIONS""""REFERENCES""""8 Kaiser Permanente's New Technology Committee: Coverage Decisionmaking in a Group Model Health Mai...""; ""THE KAISER PERMANENTE PROGRAM""; ""THE NEW TECHNOLOGY COMMITTEE""; ""CATEGORIES OF NEW TECHNOLOGIES""; ""COSTS OF NEW TECHNOLOGIES""; ""Research Done by the Committee""; ""FACTORS AFFECTING DECISIONMAKING""; ""Experimental Exclusions""; ""CONCLUSION""; ""9 Autologous Bone Marrow Transplantation: A Microcosm of the U.S. Health Care System""; ""THE CONTROVERSY SURROUNDING HDC-ABMT""; ""OUTCOMES-BASED DECISIONMAKING""; ""PAYER PERSPECTIVE""; ""PROPOSAL""; ""RATIONALE""""DISCUSSION""What information and decisionmaking processes determine how and whether an experimental medical technology becomes accepted and used? Adopting New Medical Technology reviews the strengths and weaknesses of present coverage and adoption practices, highlights opportunities for improving both the decisionmaking processes and the underlying information base, and considers approaches to instituting a much-needed increase in financial support for evaluative research. Essays explore the nature of technological change; the use of technology assessment in decisions by health care providers and federal, for-profit, and not-for-profit payers; the role of the courts in determining benefits coverage; strengthening the connections between evaluative research and coverage decisionmaking; manufacturers' responses to the increased demand for outcomes research; and the implications of health care reform for technology policy. Medical innovation at the crossroads ;v. 4.Medical innovationsCongressesHealth insuranceUnited StatesCongressesSocial medicineUnited StatesCongressesHealth care reformUnited StatesCongressesMedical innovationsHealth insuranceSocial medicineHealth care reform610Gelijns Annetine1808050Dawkins Holly V1808051Institute of Medicine (U.S.).Committee on Technological Innovation in Medicine.MiAaPQMiAaPQMiAaPQBOOK9910965599603321Adopting new medical technology4364395UNINA