title: The role of hospital payments in the adoption of new medical technologies: an international survey of current practice.
abstract: This study examined the role of prospective payment systems in the adoption of new medical technologies across different countries. A literature review was conducted to provide background for the study and guide development of a survey instrument. The survey was disseminated to hospital payment systems experts in 15 jurisdictions. Fifty-one surveys were disseminated, with 34 returned. The surveys returned covered 14 of the 15 jurisdictions invited to participate. The majority (71%) of countries update the patient classification system and/or payment tariffs on an annual basis to try to account for new technologies. Use of short-term separate or supplementary payments for new technologies occurs in 79% of countries to ensure adequate funding and facilitate adoption. A minority (43%) of countries use evidence of therapeutic benefit and/or costs to determine or update payment tariffs, although it is somewhat more common in establishing short-term payments. The main barrier to using evidence is uncertain or unavailable clinical evidence. Almost three-fourths of respondents believed diagnosis-related group systems incentivize or deter technology adoption, depending on the particular circumstances. Improvements are needed, such as enhanced strategies for evidence generation and linking evidence of value to payments, national and international collaboration and training to improve existing practice, and flexible timelines for short-term payments. Importantly, additional research is needed to understand how different payment policies impact technology uptake as well as quality of care and costs.
authors.affiliation: 1Research Fellow,LSE Health,London School of Economics and Political Science,London,UK.
authors.forename: Corinna
authors.initials: C
authors.lastname: Sorenson
authors.affiliation: 2Professor of Health Economics,Centre for Health Economics,University of York,York,UK.
authors.forename: Michael
authors.initials: M
authors.lastname: Drummond
authors.affiliation: 3Assistant Professor,CERGAS,Bocconi University,Milano,Italy.
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Torbica
authors.affiliation: 4Research Fellow,CERGAS,Bocconi University,Milano,Italy.
authors.forename: Giuditta
authors.initials: G
authors.lastname: Callea
authors.affiliation: 5Assistant Professor,National School of Public Health,Nova University of Lisbon,Lisbon,Portugal.
authors.forename: Ceu
authors.initials: C
authors.lastname: Mateus
mesh_terms: D020811:Biomedical Technology / Q000191:economics*; D003953:Diagnosis-Related Groups / Q000191:economics; D004469:Economics, Hospital / Q000458:organization & administration*; D055317:Evidence-Based Practice; D006801:Humans; D038622:Internationality; D011445:Prospective Payment System / Q000191:economics*; D011446:Prospective Studies