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Changing payment instruments and the utilisation of new medical technologies

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  • Patricia Ex

    (Technische Universität Berlin)

  • Cornelia Henschke

    (Technische Universität Berlin)

Abstract

This paper empirically investigates the impact of additional reimbursement instruments on the diffusion of new technologies in inpatient care. Using 2010–2014 German panel data on hospital level for every patient undergoing coronary angioplasty, this study examines the utilisation of drug-eluting balloon catheters (DEB) over time while additional payment instruments changed. Hypothesising that the utilisation of DEB increased abruptly when a new reimbursement instrument came into force, we estimate a fixed effects regression comparing years with a change and years where the reimbursement instrument remained the same. The model is adjusted for patient age and severity of the disease. The utilisation of DEB increased from 8407 in 2010 to 19,065 in 2014. Hospitals used significantly more DEB when an additional payment instrument changed compared to years when it remained the same. The increase was roughly twice as large. In short, hospitals are incentivised to utilise new technologies if the reimbursement changes to an instrument that is designed in a more reliable way, e.g. including less bureaucracy or guaranteeing fixed prices.

Suggested Citation

  • Patricia Ex & Cornelia Henschke, 2019. "Changing payment instruments and the utilisation of new medical technologies," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 20(7), pages 1029-1039, September.
    • Handle: RePEc:spr:eujhec:v:20:y:2019:i:7:d:10.1007_s10198-019-01056-z
    DOI: 10.1007/s10198-019-01056-z
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    Cited by:

    1. Marie Dreger & Hauke Langhoff & Cornelia Henschke, 2022. "Adoption of large-scale medical equipment: the impact of competition in the German inpatient sector," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 23(5), pages 791-805, July.
    2. Rachet-Jacquet, Laurie & Toulemon, Léa & Rochaix, Lise, 2021. "Hospital payment schemes and high-priced drugs: Evidence from the French Add-on List," Health Policy, Elsevier, vol. 125(7), pages 923-929.
    3. Meilin Möllenkamp & Benedetta Pongiglione & Stefan Rabbe & Aleksandra Torbica & Jonas Schreyögg, 2022. "Spillover effects and other determinants of medical device uptake in the presence of a medical guideline: An analysis of drug‐eluting stents in Germany and Italy," Health Economics, John Wiley & Sons, Ltd., vol. 31(S1), pages 157-178, September.

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    More about this item

    Keywords

    Additional payment instruments; Diffusion of innovations; New health technology; Hospital financing; DRG system; Panel data;
    All these keywords.

    JEL classification:

    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • C32 - Mathematical and Quantitative Methods - - Multiple or Simultaneous Equation Models; Multiple Variables - - - Time-Series Models; Dynamic Quantile Regressions; Dynamic Treatment Effect Models; Diffusion Processes; State Space Models
    • C33 - Mathematical and Quantitative Methods - - Multiple or Simultaneous Equation Models; Multiple Variables - - - Models with Panel Data; Spatio-temporal Models

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