title: Diffusion of minimally invasive therapy in The Netherlands.
abstract: In the context of the European project, the diffusion of 10 selected cases of minimally invasive therapy (MIT) in the Dutch health care system was documented and analyzed. In each case the diffusion pattern resulting from the balance of stimulating and impeding factors is described, and summarized in a matrix framework. Budgetary pressures, lack of evidence on effectiveness and physician conservatism are the most important factors impeding diffusion of MIT. Patient demand, media reporting and presence of medical innovators are important diffusion-stimulating factors. Finally, a judgment is made on the policy implications of these findings, based on a comparison of the extent and speed of the diffusion of each case, the quality of evidence on effectiveness and cost-effectiveness and, in a few cases, existing policies. In most cases, more active policy making, either stimulating or otherwise guiding diffusion, would be desirable.
authors.affiliation: Department of Health Economics, University of Limburg, Maastricht, The Netherlands.
authors.forename: H
authors.initials: H
authors.lastname: Vondeling
authors.forename: E
authors.initials: E
authors.lastname: Haerkens
authors.forename: A
authors.initials: A
authors.lastname: de Wit
authors.forename: M
authors.initials: M
authors.lastname: Bos
authors.forename: H D
authors.initials: HD
authors.lastname: Banta
mesh_terms: D015906:Angioplasty, Balloon, Coronary / Q000706:statistics & numerical data; D004059:Diffusion of Innovation; D004724:Endoscopy / Q000639:trends; D006291:Health Policy; D010535:Laparoscopy; D053685:Laser Therapy / Q000706:statistics & numerical data; D008096:Lithotripsy / Q000706:statistics & numerical data; D009403:Nephrostomy, Percutaneous / Q000706:statistics & numerical data; D009426:Netherlands; D013514:Surgical Procedures, Operative / Q000639:trends*; D013673:Technology Assessment, Biomedical