The Determinants of Technological Change in Heart Attack Treatment

47 Pages Posted: 4 Feb 1997 Last revised: 22 Jun 2012

See all articles by David M. Cutler

David M. Cutler

Harvard University - Department of Economics; National Bureau of Economic Research (NBER); Harvard University - Harvard Kennedy School (HKS)

Mark B. McClellan

Brookings Institution; Council of Economic Advisors; National Bureau of Economic Research (NBER)

Date Written: September 1996

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.

Suggested Citation

Cutler, David M. and McClellan, Mark B., The Determinants of Technological Change in Heart Attack Treatment (September 1996). NBER Working Paper No. w5751. Available at SSRN: https://ssrn.com/abstract=4612

David M. Cutler (Contact Author)

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Mark B. McClellan

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