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Technological Development and Medical Productivity: The Diffusion of Angioplasty in New York State

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David M. Cutler
Robert S. Huckman

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Abstract

A puzzling feature of many medical innovations is that they simultaneously appear to reduce unit costs and increase total costs. We consider this phenomenon by examining the diffusion of percutaneous transluminal coronary angioplasty (PTCA) -- a treatment for coronary artery disease -- over the past two decades. We find that growth in the use of PTCA led to higher total costs despite its lower unit cost. Over the two decades following PTCA's introduction, however, we find that the magnitude of this increase was reduced by between 10% and 20% due to the substitution of PTCA for CABG. In addition, the increased use of PTCA appears to be a productivity improvement. PTCAs that substitute for CABG cost less and have the same or better outcomes, while PTCAs that replace medical management appear to improve health by enough to justify the cost.

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Paper provided by National Bureau of Economic Research, Inc in its series NBER Working Papers with number 9311.

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Date of creation: Nov 2002
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Handle: RePEc:nbr:nberwo:9311

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I1 - Health, Education, and Welfare - - Health
O3 - Economic Development, Technological Change, and Growth - - Technological Change

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  1. Bronwyn Hall & Beethika Khan, 2003. "Adoption of New Technology," Department of Economics, Working Paper Series 1055, Department of Economics, Institute for Business and Economic Research, UC Berkeley. [Downloadable!]
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  2. Adriana Castelli & Diane Dawson & Hugh Gravelle & Andrew Street, 2007. "Improving the measurement of health system output growth," Health Economics, John Wiley & Sons, Ltd., vol. 16(10), pages 1091-1107. [Downloadable!]
  3. Vivian Ho, 2006. "Does certificate of need affect cardiac outcomes and costs?," International Journal of Health Care Finance and Economics, Springer, vol. 6(4), pages 300-324, December. [Downloadable!] (restricted)
  4. Robert S. Huckman, 2005. "Hospital Integration and Vertical Consolidation: An Analysis of Acquisitions in New York State," NBER Working Papers 11379, National Bureau of Economic Research, Inc. [Downloadable!] (restricted)
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  5. James B. Rebitzer & Mari Rege & Christopher Shepard, 2008. "Influence, Information Overload, and Information Technology in Health Care," NBER Working Papers 14159, National Bureau of Economic Research, Inc. [Downloadable!] (restricted)
  6. Jill R. Horwitz, 2005. "Does Corporate Ownership Matter? Service Provision in the Hospital Industry," NBER Working Papers 11376, National Bureau of Economic Research, Inc. [Downloadable!] (restricted)
  7. Jonathan Skinner & Douglas Staiger, 2005. "Technology Adoption From Hybrid Corn to Beta Blockers," NBER Working Papers 11251, National Bureau of Economic Research, Inc. [Downloadable!] (restricted)
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  8. Bech, Mickael & Christiansen, Terkel & Dunham, Kelly & Lauridsen, Jørgen & Lyttkens, Carl Hampus & McDonald, Kathryn & McGuire, Alistair & TECH investigators, the, 2006. "How do economic incentives and regulatory factors influence adoption of cardiac technologies? Result from the TECH project," Working Papers 2006:15, Lund University, Department of Economics. [Downloadable!]
  9. Jill R. Horwitz & Austin Nichols, 2007. "What Do Nonprofits Maximize? Nonprofit Hospital Service Provision and Market Ownership Mix," NBER Working Papers 13246, National Bureau of Economic Research, Inc. [Downloadable!] (restricted)
  10. Vicente Ortún & Ricard Meneu & Salvador Peiró, 2004. "El impacto de los servicios sanitarios sobre la salud," Economics Working Papers 752, Department of Economics and Business, Universitat Pompeu Fabra. [Downloadable!]
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  11. Brigitte Dormont & Michel Grignon & Hélène Huber, 2006. "Health expenditure growth : reassessing the threat of ageing," Post-Print halshs-00181605_v1, HAL. [Downloadable!]
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  12. Diane Dawson & Hugh Gravelle & Mary O'Mahony & Andrew Street & Martin Weale & Adriana Castelli & Rowena Jacobs & Paul Kind & Pete Loveridge & Stephen Martin & Philip Stevens & Lucy Stokes, 2005. "Developing new approaches to measuring NHS outputs and productivity," Working Papers 006cherp, Centre for Health Economics, University of York, revised Dec 2005. [Downloadable!]
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