title: Economic barriers to implementation of innovations in health care: is the long run-short run efficiency discrepancy a paradox?
abstract: Favourable cost-effectiveness of innovative technologies is more and more a necessary condition for implementation in clinical practice. But proven cost-effectiveness itself does not guarantee successful implementation. The reason for this is a potential discrepancy between long run efficiency, on which cost-effectiveness is based, and short run efficiency. Long run and short run efficiency is dependent upon economies of scale. This paper addresses the potential discrepancy between long run and short run efficiency of innovative technologies in healthcare, explores diseconomies of scale in Dutch hospitals and suggests what strategies might help to overcome hurdles to implement innovations due to that discrepancy.
authors.affiliation: Department of Epidemiology, Biostatistics and HTA, Radboud University Nijmegen Medical Center, HP138, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands. e.adang@mta.umcn.nl
authors.forename: Eddy M M
authors.initials: EM
authors.lastname: Adang
authors.forename: Michel
authors.initials: M
authors.lastname: Wensing
mesh_terms: D000465:Algorithms; D003362:Cost-Benefit Analysis; D003695:Delivery of Health Care; D004059:Diffusion of Innovation; D017598:Efficiency, Organizational / Q000191:economics; D013677:Medical Laboratory Science / Q000191:economics*; D009313:National Health Programs; D009426:Netherlands