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Is managed care restraining the adoption of technology by hospitals?

机译：管理式护理是否限制了医院采用技术？

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As health care costs increase, cost-control mechanisms become more widespread and it is crucial to understand their implications for the health care market. This paper examines the effect that managed care activity (based on the aim to control health care expenditure) has on the adoption of technologies by hospitals. We use a hazard rate model to investigate whether higher levels of managed care market share are associated with a decrease on medical technology adoption during the period 1982-1995. We analyze annual data on 5390 US hospitals regarding the adoption of 13 different technologies. Our results are threefold: first, we find that managed care has a negative effect on hospitals' technology acquisition for each of the 13 medical technologies in our study, and its effect is stronger for those technologies diffusing in the 1990s, when the managed care sector is at its largest. If managed care enrollment had remained at its 1984 level, there would be 5.3%, 7.3% and 4.1% more hospitals with diagnostic radiology, radiation therapy and cardiac technologies, respectively. Second, we find that the rise in managed care leads to long-term reductions in medical cost growth. Finally, we take into account that profitability analysis is one of the main dimensions considered by hospitals when deciding about the adoption of new technologies. In order to determine whether managed care affects technologies differently if they have a different cost-reimbursement ratio (CRR), we have created a unique data set with information on the cost-reimbursement for each of the 13 technologies and we find that managed care enrollment has a considerably larger negative effect on the adoption of less profitable technologies.
机译：随着医疗保健成本的增加，成本控制机制变得越来越普遍，因此了解其对医疗保健市场的影响至关重要。本文研究了管理式护理活动（基于控制医疗保健支出的目的）对医院采用技术的影响。我们使用风险率模型调查在1982-1995年期间，较高的管理式医疗市场份额是否与医疗技术采用的减少有关。我们分析了美国5390家医院采用13种不同技术的年度数据。我们的研究结果具有三个方面：首先，我们发现托管护理对我们研究中的13种医疗技术中的每一种对医院的技术获取均具有负面影响，而对于1990年代扩散的那些技术，其管理效果则更强，那时托管医疗行业最大。如果管理式护理入学率保持在1984年的水平，则分别拥有诊断放射学，放射治疗和心脏技术的医院将分别增加5.3％，7.3％和4.1％。其次，我们发现管理式护理的增加导致医疗成本增长的长期减少。最后，我们考虑到盈利能力分析是医院在决定采用新技术时考虑的主要方面之一。为了确定托管医疗是否具有不同的成本报销比率（CRR），它们是否会对技术产生不同的影响，我们创建了一个唯一的数据集，其中包含13种技术中每种技术的成本报销信息，我们发现托管医疗注册对采用利润较低的技术产生更大的负面影响。

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