title: The effects of reimbursement mechanisms on medical technology diffusion in the hospital sector in the Italian NHS.
abstract: OBJECTIVE
  The aim of this study was to investigate how the differences across the regional reimbursement mechanisms and in particular the use of the DRGs impact on the level in the high technology equipment diffusion.
  
  
  METHODS
  Based on hospital sector data at a regional level we build up indicators to measure the regional diffusion of high technological medical equipment in the period 1997-2007. These indicators are regressed on regional healthcare characteristics to investigate the relationship between the different reimbursement systems offered by Italian regions and the level of high technological medical equipment.
  
  
  RESULTS
  Our results suggest that the per-case payment system is generally associated with a lower level of regional technology endowment per million of inhabitants, especially for the complex and expensive medical equipment.
  
  
  CONCLUSIONS
  Our findings cast some doubts that an effective regulation of reimbursement mechanisms cannot limit the excessive diffusion of medical equipment that is a relevant driver of the increase in expenditure.
authors.affiliation: Mediterranean University of Reggio Calabria, Department of Law and Economics, Via Tommaso Campanella, 38/A, 89125 Reggio Calabria, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Finocchiaro Castro
authors.affiliation: University of Catania, Department of Economics and Business, Corso Italia, 55, 95121 Catania, Italy. Electronic address: cguccio@lex.unict.it.
authors.forename: Calogero
authors.initials: C
authors.lastname: Guccio
authors.affiliation: University of Catania, Department of Economics and Business, Corso Italia, 55, 95121 Catania, Italy.
authors.forename: Giacomo
authors.initials: G
authors.lastname: Pignataro
authors.affiliation: University of Catania, Department of Economics and Business, Corso Italia, 55, 95121 Catania, Italy.
authors.forename: Ilde
authors.initials: I
authors.lastname: Rizzo
mesh_terms: D020811:Biomedical Technology / Q000191:economics / Q000706:statistics & numerical data*; D003953:Diagnosis-Related Groups / Q000191:economics / Q000706:statistics & numerical data; D004059:Diffusion of Innovation; D004469:Economics, Hospital; D006761:Hospitals / Q000706:statistics & numerical data*; D006801:Humans; D007558:Italy; D009313:National Health Programs / Q000191:economics / Q000458:organization & administration / Q000706:statistics & numerical data; D012051:Reimbursement Mechanisms
keywords: DRG; Decentralization; Hospital care; Medical equipment; Prospective payment systems; Technology diffusion