title: Adoption Decisions for Medical Devices in the Field of Cardiology: Results from a European Survey.
abstract: Decisions to adopt medical devices at the hospital level have consequences for health technology assessment (HTA) on system level and are therefore important to decision makers. Our aim was to investigate the characteristics of organizations and individuals that are more inclined to adopt and utilize cardiovascular devices based on a comprehensive analysis of environmental, organizational, individual, and technological factors and to identify corresponding implications for HTA. Seven random intercept hurdle models were estimated using the data obtained from 1249 surveys completed by members of the European Society of Cardiology. The major findings were that better manufacturer support increased the adoption probability of 'new' devices (i.e. in terms of CE mark approval dates), and that budget pressure increased the adoption probability of 'old' devices. Based on our findings, we suggest investigating the role of manufacturer support in more detail to identify diffusion patterns relevant to HTA on system level, to verify whether it functions as a substitute for medical evidence of new devices, and to receive new insights about its relationship with clinical effectiveness and cost-effectiveness. © 2017 The Authors. Health Economics published by John Wiley & Sons, Ltd.
authors.affiliation: Hamburg Center for Health Economics, University of Hamburg, Germany.
authors.forename: Maximilian H M
authors.initials: MH
authors.lastname: Hatz
authors.affiliation: Hamburg Center for Health Economics, University of Hamburg, Germany.
authors.forename: Jonas
authors.initials: J
authors.lastname: Schreyögg
authors.affiliation: Centre for Research on Health and Social Care Management (CERGAS), Bocconi University, Milan, Italy.|Department of Policy Analysis and Public Management, Bocconi University, Milan, Italy.
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Torbica
authors.affiliation: Cardiology Department, University of Modena and Reggio Emilia, Modena University Hospital, Modena, Italy.|European Society of Cardiology, Sophia Antipolis, France.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Boriani
authors.affiliation: Hamburg Center for Health Economics, University of Hamburg, Germany.|Center for Gerontology and Health Care Research, School of Public Health, Brown University, Providence, RI, USA.
authors.forename: Carl R B
authors.initials: CR
authors.lastname: Blankart
mesh_terms: D000072038:Cardiac Rehabilitation / Q000191:economics / Q000295:instrumentation / Q000379:methods; D002309:Cardiology / Q000191:economics / Q000295:instrumentation* / Q000379:methods / Q000592:standards; D013504:Cardiovascular Surgical Procedures / Q000191:economics / Q000295:instrumentation; D003362:Cost-Benefit Analysis; D003659:Decision Making, Organizational; D004864:Equipment and Supplies / Q000191:economics / Q000592:standards* / Q000706:statistics & numerical data; D019538:Health Care Surveys; D006801:Humans; D019736:Prostheses and Implants / Q000191:economics / Q000592:standards / Q000706:statistics & numerical data; D013673:Technology Assessment, Biomedical / Q000191:economics / Q000379:methods / Q000592:standards*
keywords: adoption; cardiology; health technology assessment; hurdle model; medical device