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The Determinants of Technological Change in Heart Attack Treatment
David M. Cutler Harvard University - Department of Economics; National Bureau of Economic Research (NBER) Mark B. McClellan Brookings Institution; Council of Economic Advisors; National Bureau of Economic Research (NBER); Stanford Graduate School of Business September 1996 NBER Working Paper No. W5751 Abstract: This paper examines the sources of expenditure growth in heart attack treatment. We first show that essentially all of cost growth is a result of the diffusion of particular intensive technologies; the prices paid for a given level of technology have been constant or falling over time. We then examine the reasons for this technology diffusion. We distinguish six factors that may influence technology diffusion: organizational factors within hospitals; the insurance environment in which technology is reimbursed; public policy regulating new technology; malpractice concerns; competitive or cooperative interactions among providers; and demographic composition. We conclude that insurance variables, technology regulation, and provider interactions have the largest quantitative effect on technological diffusion. These factors affect both technology acquisition and the frequency of technology use.
JEL Classifications: I1, O3, H51 Working Paper SeriesDate posted: February 04, 1997 ; Last revised: May 16, 2000Suggested CitationContact Information
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