LEADER 06476nam 2200817Ia 450 001 9910965599603321 005 20251116140711.0 010 $a9786610211210 010 $a9781280211218 010 $a1280211210 010 $a9780309586412 010 $a0309586410 010 $a9780585001753 010 $a0585001758 035 $a(CKB)110986584751410 035 $a(EBL)3376266 035 $a(SSID)ssj0000097486 035 $a(PQKBManifestationID)11121536 035 $a(PQKBTitleCode)TC0000097486 035 $a(PQKBWorkID)10119344 035 $a(PQKB)10625916 035 $a(MiAaPQ)EBC3376266 035 $a(Au-PeEL)EBL3376266 035 $a(CaPaEBR)ebr10055317 035 $a(CaONFJC)MIL21121 035 $a(OCoLC)923262428 035 $a(Perlego)4738793 035 $a(BIP)13279 035 $a(EXLCZ)99110986584751410 100 $a19940302d1994 uy 0 101 0 $aeng 135 $aur|n|---||||| 181 $ctxt 182 $cc 183 $acr 200 00$aAdopting new medical technology /$fAnnetine C. Gelijns and Holly V. Dawkins, editors ; Committee on Technological Innovation in Medicine, Institute of Medicine 205 $a1st ed. 210 $aWashington, D.C. $cNational Academy Press$d1994 215 $a1 online resource (240 p.) 225 1 $aMedical innovation at the crossroads ;$vv. 4 300 $a"Proceedings of the fourth workshop in the series 'Examining coverage and adoption decisions about medical technologies,' held in Washington, D.C., on September 18-19, 1992"--T.p. verso. 311 08$a9780309050357 311 08$a0309050359 320 $aIncludes bibliographical references and index. 327 $a""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"" 327 $a""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"" 327 $a""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"" 327 $a""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"" 327 $a""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"" 327 $a""DISCUSSION"" 330 $aWhat information and decisionmaking processes determine how and whether an experimental medical technology becomes accepted and used? Adopting New Medical Technology reviews the strengths and weaknesses of present coverage and adoption practices, highlights opportunities for improving both the decisionmaking processes and the underlying information base, and considers approaches to instituting a much-needed increase in financial support for evaluative research. Essays explore the nature of technological change; the use of technology assessment in decisions by health care providers and federal, for-profit, and not-for-profit payers; the role of the courts in determining benefits coverage; strengthening the connections between evaluative research and coverage decisionmaking; manufacturers' responses to the increased demand for outcomes research; and the implications of health care reform for technology policy. 410 0$aMedical innovation at the crossroads ;$vv. 4. 606 $aMedical innovations$vCongresses 606 $aHealth insurance$zUnited States$vCongresses 606 $aSocial medicine$zUnited States$vCongresses 606 $aHealth care reform$zUnited States$vCongresses 615 0$aMedical innovations 615 0$aHealth insurance 615 0$aSocial medicine 615 0$aHealth care reform 676 $a610 701 $aGelijns$b Annetine$01808050 701 $aDawkins$b Holly V$01808051 712 02$aInstitute of Medicine (U.S.).$bCommittee on Technological Innovation in Medicine. 801 0$bMiAaPQ 801 1$bMiAaPQ 801 2$bMiAaPQ 906 $aBOOK 912 $a9910965599603321 996 $aAdopting new medical technology$94364395 997 $aUNINA