Another Special Relationship? Interactions between Health Technology Policies and Health Care Systems in the United States and the United Kingdom
Columbia University.Journal of Health Politics Policy and Law (Impact Factor: 1.37). 02/2011; 36(1):119-39. DOI: 10.1215/03616878-1191126
Confronted with similar challenges, the United States and the United Kingdom have adopted very different health technology policies. In the United States, the focus has been on technology creation, in particular the funding of basic biomedical research at the National Institutes of Health. This both reflects and reinforces an innovation-first culture in the United States, including in health. By contrast, the United Kingdom has been much more heavily committed to applied research and evaluative research, including health-technology assessment. That is, while U.S. policy has focused on technology creation, U.K. policy has been more oriented toward technology diffusion. This article surveys the sources of these differences. We consider the impacts of institutional, cultural, and other factors that may explain them, and emphasize that it is hard to disentangle the separate effects of those factors. We conclude with a discussion of the difficulties in drawing cross-national lessons in health technology policy.
Science and Public Policy 08/2015; DOI:10.1093/scipol/scv051 · 0.98 Impact Factor
- "By bringing forward the worldview and mandate of those who finance the development of new medical technology, this paper highlights the perplexing absence of health policy considerations in the decisions that give shape to health technology (Sampat and Drummond 2011). We focus our attention on the financing of academic spin-offs, which are small firms created by entrepreneurial academics and clinicians in order to develop and bring a new health technology to market. "
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ABSTRACT: This article presents the findings from a study trip to Kaiser Permanente (KP), a private healthcare provider in the USA. The aim of the trip was to understand how healthcare integration is managed in KP and how this might help patients in the UK with motor neurone disease (MND). This article makes reference to the American and British healthcare systems, identifying the simple differences between health economies, and their impact on health care, with specific reference to MND. The trip was undertaken as part of the author's ongoing work on how patients with MND rate services delivered by the multidisciplinary team (MDT) in the UK. The author's community matron role involves caring for patients with long-term conditions (LTCs) including long-term neurological conditions (LTNCs). In executing this role and in service delivery to patients with LTNCs, specifically MND, the author noticed a lack of robust integration, highlighting the need to consider and address the various contributory factors. This article presents a literature review and analyses the role of the MDT including specialist neurological professionals in executing duties and in delivering healthcare services to patients diagnosed with MND. The implications for practice are also presented along with areas for practice development.British journal of nursing (Mark Allen Publishing) 11/2013; 22(20):1182-8. DOI:10.12968/bjon.2013.22.20.1182
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ABSTRACT: To evaluate the association of technological capacity with prostate cancer quality of care. Technological capacity was conceptualized as a market's ability to provide prostate cancer treatment with new technology, including robotic prostatectomy and intensity-modulated radiotherapy (IMRT). In this retrospective cohort study, we used data from the Surveillance, Epidemiology, and End Results-Medicare linked database from 2004 to 2009 to identify men with newly diagnosed prostate cancer (n = 46,274). We measured technological capacity as the number of providers performing robotic prostatectomy or IMRT per population in a health care market. We used multilevel logistic regression analysis to assess the association of technological capacity with receiving quality care according to a set of nationally endorsed quality measures, while adjusting for patient and market characteristics. Overall, our findings were mixed with only subtle differences in quality of care comparing high-tech with low-tech markets. High robotic prostatectomy capacity was associated with better adherence to some quality measures, such as avoiding unnecessary bone scans (79.8% vs 73.0%; P = .003) and having follow-up with urologists (67.7% vs 62.6%; P = .023). However, for most measures, neither high robotic prostatectomy nor high-IMRT capacity was associated with significant increases in adherence rates. In fact, for 1 measure (treatment by a high-volume provider), high-IMRT capacity was associated with lower performance (23.4% vs 28.5%; P <.001). Our findings suggest that new technology is not clearly associated with higher quality of care. To improve quality, more specific efforts will be needed. Published by Elsevier Inc.Urology 10/2014; 84(5). DOI:10.1016/j.urology.2014.06.067 · 2.19 Impact Factor
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