Hostname: page-component-cd9895bd7-p9bg8 Total loading time: 0 Render date: 2024-12-19T01:43:44.826Z Has data issue: false hasContentIssue false

Diffusion of published cost-utility analyses in the field of health policy and practice

Published online by Cambridge University Press:  04 August 2005

Seema S. Sonnad
Affiliation:
University of Pennsylvania
Dan Greenberg
Affiliation:
Ben-Gurion University of Negev
Allison B. Rosen
Affiliation:
University of Michigan
Peter J. Neumann
Affiliation:
Harvard School of Public Health

Abstract

Objectives: The diffusion of cost-utility analyses (CUAs) through the medical literature was examined, documenting visible patterns and determining how they correspond with expectations about the diffusion of process innovations.

Methods: This study used 539 CUAs from a registry. It includes data elements comprising year of publication, the research center in which the study was performed, the clinical area covered by the CUA, and the specific journal. Finally, each paper was assigned to a journal type that could be one of the three categories: health services research, general medicine, or clinical specialty.

Results: When the average number of publications is plotted against time, the plot reveals an S-shaped curve. It appears that, whereas CUAs initially were published more frequently in general medical or health services research journals, there was a clear increase in the diffusion of CUA into subspecialty journals over time. The concentration ratio for research centers as measured by the Herfindhal–Hirschman Index decreased over time.

Conclusions: The spread of CUA through the medical literature follows patterns identified for the diffusion of other new technologies and processes. Future research should focus on what impact this spread has had on the practice of medicine and formulation of health policy.

Type
RESEARCH REPORTS
Copyright
© 2005 Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Berwick DM. 2003 Disseminating innovations in health care. JAMA. 289: 19691975.Google Scholar
Birch S, Gafni A. 2004 The “NICE” approach to technology assessment: An economics perspective. Health Care Manag Sci. 7: 3541.Google Scholar
Gold MR, Siegel JE, Russell LB, Weinstein MC. 1996. Cost-effectiveness in health and medicine. New York, NY: Oxford University Press;
Hoffmann C, Graf von der Schulenburg JM. 2000 The influence of economic evaluation studies on decision making. A European survey. The EUROMET group. Health Policy. 52: 179192.Google Scholar
Hutton J, Brown RE. 2002 Use of economic evaluation in decision-making: What needs to change? Value Health. 5: 6566.Google Scholar
Mahajan V, Peterson RA. 1985. Models for innovation diffusion. Series: Quantitative Applications in the Social Sciences. Beverly Hills: Sage Publications;
Neumann PJ. 2004 Why don't Americans use cost-effectiveness analysis? Am J Manag Care. 10: 308312.Google Scholar
Prosser LA, Koplan JP, Neumann PJ, Weinstein MC. 2000 Barriers to using cost-effectiveness analysis in managed care decision making. Am J Manag Care. 6: 173179.Google Scholar
Rogers EM. Diffusion of Innovations. Fourth ed. New York, NY: Free Press.
Singer S, Bergthold L, Vorhaus C, et al. 1999. Decreasing variation in medical necessity decision making: Final report to the California Health Care Foundation. Stanford, CA: Center for Health Policy, Stanford University;
Sloan FA, Whetten-Goldstein K, Wilson A. 1997 Hospital pharmacy decisions, cost containment, and the use of cost-effectiveness analysis. Soc Sci Med. 45: 523533.Google Scholar