The influence of economic incentives and regulatory factors on the adoption of treatment technologies: a case study of technologies used to treat heart attacks

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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. Copyright © 2008 John Wiley & Sons, Ltd.