A comparison of the investment in hospital-based obstetrical ultrasound in Wales and Washington state.
The purpose of this study was to examine differences in the way Britain and the United States invest in and deploy a new medical technology. We used structured interviews to obtain information on the technical sophistication and approximate replacement value of all hospital-based obstetrical ultrasound machines in every maternity hospital in Washington state and Wales. The supply of hospital-based ultrasound machines--approximately two machines per 1,000 births--was similar in both countries. Wales had fewer advanced ultrasound machines than Washington state, and they were based exclusively in high-volume district general hospitals; there were no obstetric ultrasound machines in the private sector. In Washington state, the majority of advanced machines were in small and medium-sized hospitals, and many private offices had ultrasound machines. The approximate replacement value of hospital-based machines was three times as high per birth in Washington state as in Wales. In the case of obstetrical ultrasound, centralization of facilities, a relatively small private sector, and global budgeting lead to lower expenditures per patient within the National Health Service without compromising access to care.
Rosenblatt
R A
RA
University of Washington School of Medicine, USA.
Dawson
A J
AJ
Larson
E H
EH
Tressler
C J
CJ
Jones
A
A
Hart
L G
LG
Nesbitt
T S
TS
D001723:Birth Rate; D002201:Capital Expenditures / Q000706:statistics & numerical data*; D003363:Cost Control; D004059:Diffusion of Innovation; D005260:Female; D006276:Health Facility Size; D017721:Hospital Costs; D006801:Humans; D007449:Investments / Q000706:statistics & numerical data; D009775:Obstetrics and Gynecology Department, Hospital / Q000191:economics*; D011247:Pregnancy; D011787:Quality of Health Care; D016216:Ultrasonography, Prenatal / Q000191:economics / Q000295:instrumentation*; D014852:Wales; D014861:Washington