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Decisions to adopt new technologies at the hospital level: Insights from Israeli medical centers

Published online by Cambridge University Press:  26 April 2005

Dan Greenberg ,
Yitzhak Peterburg ,
Daniel Vekstein  and
Joseph S. Pliskin
Dan Greenberg
Affiliation:
Ben-Gurion University of the Negev
Yitzhak Peterburg
Affiliation:
Ben-Gurion University of the Negev
Daniel Vekstein
Affiliation:
Achva Academic College
Joseph S. Pliskin
Affiliation:
Ben-Gurion University of the Negev
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Abstract

Objectives: New medical technologies have been identified as the leading cause of increasing health-care expenditures. Adoption of a new technology is one of the most important decisions in medical centers. The objectives of this study were to map and describe the function of hospital decision-makers within the area of new technology assessment and adoption, and to examine relevant considerations, sources of information, and decision-making processes in the adoption of a new technology.

Methods: A questionnaire was mailed to hospital executives and referred to (i) the considerations for and against adoption of a new technology, (ii) the decision-making process, (iii) information sources used in the decision-making process.

Results: The most frequent criteria favoring adoption included increased cost-effectiveness, increased efficacy, and decrease in complication rates. An increase in complication rates or side effects and decreased efficacy were the top ranked criteria against adoption. The final decision-making responsibility varied among technologies; the medical director frequently made the final decision when a new device was involved, but this responsibility decreased when a new drug or a new procedure was considered. Participation in scientific meetings, opinions of local experts, medical journals, and Food and Drug Administration clearance documents were the most important information sources used in the decision-making process. However, these were not necessarily the optimal sources of information. Significant barriers in adoption decision-making are lack of timely data regarding the safety of the new technology, its cost-effectiveness, and efficacy.

Conclusion: To improve the adoption decisions, hospitals must develop criteria upon which the decision-making will be based.

Keywords

HospitalsTechnology adoptionDecision-makingDiffusion of innovationHealth technology assessment
Type
GENERAL ESSAYS
Information
International Journal of Technology Assessment in Health Care , Volume 21 , Issue 2 , April 2005 , pp. 219 - 227
Copyright
© 2005 Cambridge University Press

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References

Anderson GF, Steinberg EP. 1994: Role of the hospital in acquisition of technology. In: Holly VD, ed. Adopting new medical technology. Washington DC: National Academy Press; 61– 70.
Anderson HJ. 1990 Survey identifies trends in equipment acquisitions. Hospitals. 64: 30, 32– 35.Google Scholar
Cutler DM, McClellan M. 2001 Is technological change in medicine worth it? Health Aff (Millwood). 20: 11– 29.Google Scholar
Feldstein PJ. 1999. Health care economics. 5th ed. New York: Delmer Publishers;
Focke A, Stummer C. 2003 Strategic technology planning in hospital management. OR Spectrum. 25: 161– 182.Google Scholar
Greenberg D, Pliskin JS, Peterburg Y. 2003 Decision making in acquiring medical technologies in Israeli medical centers: A preliminary study. Int J Technol Assess Health Care. 19: 194– 201.Google Scholar
Greer AL. 1985 Adoption of medical technology. The hospital's three decision systems. Int J Technol Assess Health Care. 1: 669– 680.Google Scholar
Greer AL. 1988 The state of the art versus the state of the science. The diffusion of new medical technologies into practice. Int J Technol Assess Health Care. 4: 5– 26.Google Scholar
Griner PF. New technology adoption in the hospital. 1992: In: Gelijns AC, ed. Technology and health care in an era of limits. Washington DC: National Academy Press; 123– 132.
Menon D, Marshall D. 1990 Technology assessment in teaching hospitals. Dimens Health Serv. 67: 26– 28.Google Scholar
Newhouse JP. 1993 An iconoclastic view of health cost containment. Health Aff (Millwood). 12: 152– 171.Google Scholar
Poulsen PB, Adamsen S, Vondeling H, Jorgensen T. 1998 Diffusion of laparoscopic technologies in Denmark. Health Policy. 45: 149– 167.Google Scholar
Rogers EM. 1995. Diffusion of innovations. 4th ed. New York: The Free Press;
Rosen B. 2003. Health care systems in transition: Israel. In: Mossialos E, ed. Copenhagen: European Observatory on Health Care Systems;
Shani S, Siebzehner MI, Luxenburg O, Shemer J. 2000 Setting priorities for the adoption of health technologies on a national level—the Israeli experience. Health Policy. 54: 169– 185.Google Scholar
Shemer J, Morginstin T, Hammerman A, Luxenburg O, Shani S. 2003 [Promoting medical technologies in the national list of health services: 1995-2000]. Harefuah. 142: 82– 86.Google Scholar
Sloan FA, Whetten-Goldstein K, Wilson A. 1997 Hospital pharmacy decisions, cost containment, and the use of cost-effectiveness analysis. Soc Sci Med. 45: 523– 533.Google Scholar
Steiner CA, Powe NR, Anderson GF, Das A. 1996 The review process used by US health care plans to evaluate new medical technology for coverage. J Gen Intern Med. 11: 294– 302.Google Scholar
Steiner CA, Powe NR, Anderson GF, Das A. 1997 Technology coverage decisions by health care plans and considerations by medical directors. Med Care. 35: 472– 489.Google Scholar
Teplensky JD, Pauly MV, Kimberly JR, Hillman AL, Schwartz JS. 1995 Hospital adoption of medical technology: An empirical test of alternative models. Health Serv Res. 30: 437– 465.Google Scholar
Weingart SN. 1993 Acquiring advanced technology. Decision-making strategies at twelve medical centers. Int J Technol Assess Health Care. 9: 530– 538.Google Scholar
Weingart SN. 1995 Deciding to buy expensive technology. The case of biliary lithotripsy. Int J Technol Assess Health Care. 11: 301– 315.Google Scholar