06645nam 2200817Ia 450 991097371500332120251116140427.097866102032089781280203206128020320X9780309561891030956189297805850282550585028257(CKB)110986584751170(EBL)3377246(SSID)ssj0000256498(PQKBManifestationID)11193768(PQKBTitleCode)TC0000256498(PQKBWorkID)10225503(PQKB)10617711(MiAaPQ)EBC3377246(Au-PeEL)EBL3377246(CaPaEBR)ebr10068488(CaONFJC)MIL20320(OCoLC)923269215(Perlego)4738848(BIP)1576415(EXLCZ)9911098658475117019920615d1992 uy 0engur|n|---|||||txtccrTechnology and health care in an era of limits /Annetine C. Gelijns, editor ; Committee on Technological Innovation in Medicine, Institute of Medicine1st ed.Washington, D.C. National Academy Press19921 online resource (296 p.)Medical innovation at the crossroads ;v. 3Papers presented at the third Institute of Medicine workshop "The Changing Health Care Economy," held April 18-19, 1991, supported by the Howard Hughes Medical Institute, Pfizer, Inc., and the Health Industry Manufacturers Association.9780309046954 0309046955 Includes bibliographical references and index.""Technology and Health Care in an Era of Limits""; ""Copyright""; ""Acknowledgments""; ""Contents""; ""List of Abbreviations""; ""Part I Setting the Stage""; ""1 Introduction""; ""References""; ""2 Innovation and the Policies of Limits in a Changing Health Care Economy""; ""THE SHAPE OF MEDICINE'S BENEFIT-UTILIZATION CURVE""; ""WHICH RATE IS RIGHT?""; ""REFORM OF THE DOCTOR-PATIENT RELATIONSHIP""; ""LINKAGE BETWEEN THE SUPPLY OF RESOURCES AND MEDICINE'S IMPLICIT THEORIES OF EFFICACY""; ""SEEKING LIMITS""; ""INNOVATION AND THE POLICIES OF LIMITS""; ""References""""Part II Managing Care in the United States""""3 The Growth of Managed Care in the Private Sector""; ""EMPLOYER-PROVIDED HEALTH CARE BENEFITS IN THE UNITED STATES""; ""MANAGED CARE AND ITS GROWTH IN THE PRIVATE SECTOR""; ""IMPLICATIONS OF MANAGED CARE FOR TECHNOLOGY DEVELOPMENT AND DISSEMINATION""; ""References""; ""4 Managing Medical Practice: The Potential of HMOs""; ""MANAGING CARE AT GHC""; ""BREAST CANCER SCREENING""; ""THE HMO AS EFFECTIVENESS LABORATORY""; ""CONCLUSION""; ""References""; ""5 Cost Containment Efforts in the Public Sector: Oregon's Priority List""""RATIONALE AND BACKGROUND""""RANKING METHODOLOGY""; ""RESULTS""; ""DISCUSSION""; ""ACKNOWLEDGMENTS""; ""References""; ""Part III Managing Care in the United Kingdom and Canada""; ""6 Priority Setting in a Needs-based System""; ""PROBLEMS OF THE BRITISH HEALTH CARE SYSTEM""; ""THE ""REFORMED"" BRITISH HEALTH CARE SYSTEM""; ""IMPLICATIONS FOR TECHNOLOGICAL ADVANCE IN MEDICINE""; ""RATIONING HEALTH CARE: IS IT ETHICAL?""; ""7 The Meeting of the Twain: Managing Health Care Capital, Capacity, and Costs in Canada""; ""WHAT MAKES CANADIAN HEALTH CARE DIFFERENT?""; ""SO HOW DOES CANADA DO IT?""""Managing Operations""""Managing Capital""; ""FROM MACRO- TO MICROMANAGEMENT AND BACK AGAIN?""; ""THE FUTURE OF HEALTH CARE MANAGEMENT IN CANADA""; ""References""; ""Part IV Implications for Providers""; ""8 New Technology Adoption in the Hospital""; ""NEW TECHNOLOGY: WHAT ARE ITS COMPONENTS?""; ""FACTORS INFLUENCING THE ADOPTION AND USE OF TECHNOLOGY""; ""Method of Financing""; ""Recovery of Operating Costs""; ""Regulatory Equity""; ""Level of Competition""; ""Other Factors That Influence the Adoption of New Technology""; ""Hidden New Technology""; ""SUMMARY""; ""REFERENCES""""9 Physicians' Acquisition and Use of New Technology in an Era of Economic Constraints""""DIFFUSION OF MAGNETIC RESONANCE IMAGING INTO CLINICAL PRACTICE""; ""Regulation of Magnetic Resonance Imaging Acquisition""; ""The Food and Drug Administration""; ""Certificate of Need Regulations""; ""Reimbursement for Magnetic Resonance Imaging""; ""Competition Over Magnetic Resonance Imaging""; ""Summary: The Acquisition of Magnetic Resonance Imaging""; ""TECHNOLOGY ACQUISITION IN THE ""NEW HEALTH CARE"" ERA""; ""Nature of Technology""; ""Hospitals and Regulation""; ""Competition for Patients""""Reimbursement""The U.S. health care system is in a state of flux, and changes currently under way seem capable of exerting sizable effects on medical innovation. This volume explores how the rapid transition to managed care might affect the rate and direction of medical innovation. The experience with technological change in medicine in other nations whose health care systems have "single-payer" characteristics is thoroughly examined. Technology and Health Care in an Era of Limits examines how financing and care delivery strategies affect the decisions made by hospital administrators and physicians to adopt medical technologies. It also considers the patient's stake in the changing health care economy and the need for a stronger independent contribution of patients to the choice of technology used in their care. Finally, the volume explores the impact of changes in the demand for medical technology in pharmaceutical, medical device, and surgical procedure innovation.Medical innovation at the crossroads ;v. 3.Managed care plans (Medical care)CongressesMedical careUnited StatesCongressesMedical technologyEffect of managed care onUnited StatesManaged care plans (Medical care)Medical careMedical technologyEffect of managed care on362.1Gelijns Annetine1808050Institute of Medicine (U.S.).Committee on Technological Innovation in Medicine.Howard Hughes Medical Institute.Pfizer Inc.Health Industry Manufacturers Association.MiAaPQMiAaPQMiAaPQBOOK9910973715003321Technology and health care in an era of limits4366679UNINA