title: The influence of economic incentives and regulatory factors on the adoption of treatment technologies: a case study of technologies used to treat heart attacks.
abstract: The Technological Change in Health Care Research Network collected unique patient-level data on three procedures for treatment of heart attack patients (catheterization, coronary artery bypass grafts and percutaneous transluminal coronary angioplasty) for 17 countries over a 15-year period to examine the impact of economic and institutional factors on technology adoption. Specific institutional factors are shown to be important to the uptake of these technologies. Health-care systems characterized as public contract systems and reimbursement systems have higher adoption rates than public-integrated health-care systems. Central control of funding of investments is negatively associated with adoption rates and the impact is of the same magnitude as the overall health-care system classification. GDP per capita also has a strong role in initial adoption. The impact of income and institutional characteristics on the utilization rates of the three procedures diminishes over time.
authors.affiliation: Institute of Public Health, University of Southern Denmark, Odense C, Denmark. mbe@sam.sdu.dk
authors.forename: Mickael
authors.initials: M
authors.lastname: Bech
authors.forename: Terkel
authors.initials: T
authors.lastname: Christiansen
authors.forename: Kelly
authors.initials: K
authors.lastname: Dunham
authors.forename: Jørgen
authors.initials: J
authors.lastname: Lauridsen
authors.forename: Carl Hampus
authors.initials: CH
authors.lastname: Lyttkens
authors.forename: Kathryn
authors.initials: K
authors.lastname: McDonald
authors.forename: Alistair
authors.initials: A
authors.lastname: McGuire
mesh_terms: D019049:Developed Countries; D004059:Diffusion of Innovation; D006801:Humans; D013677:Medical Laboratory Science / Q000191:economics* / Q000331:legislation & jurisprudence*; D017202:Myocardial Ischemia / Q000628:therapy*; D019982:Organizational Case Studies; D012052:Reimbursement, Incentive