Adoption And Spread Of New Imaging Technology: A Case Study
Joseph A. Ladapo 1*,
Jill R. Horwitz 2,
Milton C. Weinstein 3,
G. Scott Gazelle 4,
David M. Cutler 5
1 Joseph Ladapo is a clinical fellow in the Department of Medicine at Beth Israel Deaconess Medical Center in Boston, Massachusetts.
2 Jill Horwitz is a professor of business and law at the University of Michigan Law School in Ann Arbor.
3 Milton Weinstein is a professor of health policy and management at the Harvard School of Public Health in Boston.
4 Scott Gazelle is a professor of radiology at Harvard Medical School, also in Boston.
5 David Cutler is a professor of economics at Harvard University in Cambridge, Massachusetts.
*Corresponding author.
Technology is a major driver of health care costs. Hospitals are rapidly acquiring one new technology in particular: 64-slice computed tomography (CT), which can be used to image coronary arteries in search of blockages. We propose that it is more likely to be adopted by hospitals that treat cardiac patients, function in competitive markets, are reimbursed for the procedure, and have favorable operating margins. We find that early adoption is related to cardiac patient volume but also to operating margins. The paucity of evidence informing this technology's role in cardiac care suggests that its adoption by cardiac-oriented hospitals is premature. Further, adoption motivated by operating margins reinforces concerns about haphazard technology acquisition. [Health Aff (Millwood). 2009;28 (6):w1122-32 (published online 14 October 2009; 10.1377/hlthaff.28.6.w1122)]
Key Words:
Access To Care, Business Of Health, Chronic Care, Consumer Issues, Research And Technology, Health Spending