Technology in American Health Care

by Cohen, Alan B.

• ISBN13: 9780472113262
• ISBN10: 0472113267
• Format: Hardcover
• Copyright: 2004-03-01
• Publisher: Univ of Michigan Pr

Summary

"The definitive overview of health technology assessment in the U.S. and Europe, the biotech industry, adoption and use of medtech in health care." ---The World Future Society,Best Books and Reports "This excellent book provides a broad overview of the development, impact, and evaluation of health technology in the United States. . . .The authors take a well-organized and thorough approach to address these topics, combining reviews of each with case examples of particular technologies. . . .Given the broad scope of the book, it could serve as a text for students, an introduction to the field for healthcare professionals, or a tool for academics and policymakers wishing to fill knowledge gaps outside their disciplines. . . .The book makes a compelling case for the logic and potential benefits of medical technology evaluation as a tool for improving health care." ---Journal of the American Medical Association "By being comprehensive in their review, the authors chart a clear path to understanding the future of health care technology in America. They clarify the technical methods for evaluation and provide insight into the sociopolitical aspects of development and diffusion. Case studies are informative. Excellent reading for students and health professionals either as a textbook or as an off-the-shelf guide to methods for deciding among alternative technologies." ---Norman W. Weissman, University of Alabama "Technology today dominates every aspect of health care. This useful book offers a diverse range of perspectives for students, professors, and medical practitioners who wish to understand how to evaluate medical technology." ---Joel Howell, University of Michigan Medical School Technology in American Health Careis a comprehensive, multidisciplinary guide to understanding how medical advances-new drugs, biological devices, and surgical procedures-are developed, brought to market, evaluated, and adopted into health care. Cost-effective delivery of evidence-based health care is the sine qua non of American medicine in the twenty-first century. Health care decision makers, providers, payers, policymakers, and consumers all need vital information about the risks, benefits, and costs of new technologies in order to make informed decisions about which ones to adopt and how to use them. Alan B. Cohen and Ruth S. Hanft explore the evolving field of medical technology evaluation (MTE), as well as the current controversies surrounding the evaluation and diffusion of medical technologies, including the methods employed in their assessment and the policies that govern their adoption and use. The book opens with an introduction that provides basic definitions and the history of technological change in American medicine, and a second chapter that explores critical questions regarding medical technology in health care. Part I discusses biomedical innovation, the development and diffusion of medical technology, and the adoption and use of technology by hospitals, physicians, and other health care organizations and professions under changing health care market conditions. Part II examines the methods of MTE-including randomized controlled trials, meta-analyses, economic evaluation methods (such as cost-benefit, cost-effectiveness, and cost-utility analyses), and clinical decision analysis. Part III focuses on key public policy issues and concerns that affect the organization, financing, and delivery of health care and that relate importantly to medical technology, including safety, efficacy, quality, cost, access, equity, social, ethical, legal, and evaluation concerns. All three parts of the book provide a historical perspective on the relevant issues, methods, and policy concerns and contain examples of technologies whose development, adoption, evaluation, and use have contributed to our understanding of the field. This book will be invaluable in ma

Table of Contents

List of Figures	vii
List of Tables	ix
Foreword	xi
Preface	xiii
Introduction	1	(14)
Alan B. Cohen
Critical Questions Regarding Medical Technology and Its Effects	15	(30)
Alan B. Cohen
Part I: The Development, Diffusion, and Adoption of Medical Technology
Biomedical Innovation and the Development of Medical Technology	45	(34)
Alan B. Cohen
The Diffusion of New Medical Technology	79	(26)
Alan B. Cohen
The Adoption and Use of Medical Technology in Health Care Organizations	105	(46)
Alan B. Cohen
Part II: Medical Technology Evaluation
The Evaluation of Clinical Safety and Efficacy	151	(27)
Ruth S. Hanft
Alan B. Cohen
Catherine C. White
Economic Evaluation Methods	178	(22)
William E. Encinosa
Alan B. Cohen
Clinical Decision Analysis	200	(19)
William E. Encinosa
Medical Technology Evaluation in the United States and Selected Other Countries	219	(32)
Alan B. Cohen
Ruth S. Hanft
Part III. Policy Issues and Concerns
Safety and Efficacy Concerns: Medical Technology and Market Entry	251	(26)
Alan B. Cohen
Shirley A. Stewart
Quality Concerns: Medical Technology Use and Evidence-Based Clinical Practice	277	(25)
Alan B. Cohen
Shirley A. Stewart
Ruth S. Hanft
Cost Concerns: Medical Technology and Health Care Payment Policies	302	(27)
Alan B. Cohen
Ruth S. Hanft
Access and Equity Concerns: Medical Technology and System Capacity Controls	329	(21)
Alan B. Cohen
Ruth S. Hanft
Social, Ethical, and Legal Concerns: Experimentation, Rationing, and Practice Standards	350	(14)
Ruth S. Hanft
Stephanie M. Spernak
Evaluation Concerns: Medical Technology Evaluation in the Future	364	(19)
Alan B. Cohen
Ruth S. Hanft
Appendix: List of Acronyms	383	(4)
References	387	(46)
List of Contributors	433	(4)
Index	437