IDEAS home Printed from https://ideas.repec.org/a/inm/ormnsc/v49y2003i5p599-617.html
   My bibliography  Save this article

The Utilization of Competing Technologies Within the Firm: Evidence from Cardiac Procedures

Author

Listed:
  • Robert S. Huckman

    (Harvard Business School, T17 Morgan Hall, Boston, Massachusetts 02163)

Abstract

This paper examines the role of technological status in determining the rates at which competing techniques are used within a firm. Consistent with prior studies, technological status is measured on the basis of an actor's prior contributions to the body of knowledge concerning a given technique. The empirical analysis considers two treatments for coronary artery disease (CAD), each of which is associated with a distinct professional group within a hospital. These two groups are often characterized as engaging in a "turf war" for patients. After controlling for several factors that might explain technological choice---the clinical severity of patients, the relative quality of the two procedures at a given facility, firm-level financial performance, and other firm-level characteristics---I find that the technological status of the group associated with each technique affects the relative rate at which it is used within a given hospital. Moreover, this effect is strongest for patients at the margin between the two techniques. These results suggest that viewing the choice between competing innovations as a single, firm-level decision may not always capture the true dynamics underlying such a situation.

Suggested Citation

  • Robert S. Huckman, 2003. "The Utilization of Competing Technologies Within the Firm: Evidence from Cardiac Procedures," Management Science, INFORMS, vol. 49(5), pages 599-617, May.
    • Handle: RePEc:inm:ormnsc:v:49:y:2003:i:5:p:599-617
    DOI: 10.1287/mnsc.49.5.599.15145
    as

    Download full text from publisher

    File URL: http://dx.doi.org/10.1287/mnsc.49.5.599.15145
    Download Restriction: no
    File URL: https://libkey.io/10.1287/mnsc.49.5.599.15145?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Manuel Trajtenberg, 1990. "A Penny for Your Quotes: Patent Citations and the Value of Innovations," RAND Journal of Economics, The RAND Corporation, vol. 21(1), pages 172-187, Spring.
    2. Arthur, W Brian, 1989. "Competing Technologies, Increasing Returns, and Lock-In by Historical Events," Economic Journal, Royal Economic Society, vol. 99(394), pages 116-131, March.
    3. Thomas G. McGuire & Mark V. Pauly, 1991. "Physician Response to Fee Changes with Multiple Payers," Papers 0015, Boston University - Industry Studies Programme.
    4. Sharon Oster, 1982. "The Diffusion of Innovation among Steel Firms: The Basic Oxygen Furnace," Bell Journal of Economics, The RAND Corporation, vol. 13(1), pages 45-56, Spring.
    5. Daniel P. Kessler & Mark B. McClellan, 2000. "Is Hospital Competition Socially Wasteful?," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 115(2), pages 577-615.
    6. David, Paul A, 1985. "Clio and the Economics of QWERTY," American Economic Review, American Economic Association, vol. 75(2), pages 332-337, May.
    7. Baker, Laurence C., 2001. "Managed care and technology adoption in health care: evidence from magnetic resonance imaging," Journal of Health Economics, Elsevier, vol. 20(3), pages 395-421, May.
    8. Judith K. Hellerstein, 1998. "The Importance of the Physician in the Generic Versus Trade-Name Prescription Decision," RAND Journal of Economics, The RAND Corporation, vol. 29(1), pages 108-136, Spring.
    9. Nancy L. Rose & Paul L. Joskow, 1990. "The Diffusion of New Technologies: Evidence from the Electric Utility Industry," RAND Journal of Economics, The RAND Corporation, vol. 21(3), pages 354-373, Autumn.
    10. Jennifer F. Reinganum, 1981. "Market Structure and the Diffusion of New Technology," Bell Journal of Economics, The RAND Corporation, vol. 12(2), pages 618-624, Autumn.
    11. Iain Cockburn & Rebecca Henderson & Scott Stern, 1999. "The Diffusion of Science-Driven Drug Discovery: Organizational Change in Pharmaceutical Research," NBER Working Papers 7359, National Bureau of Economic Research, Inc.
    12. Gary P. Pisano & Richard M.J. Bohmer & Amy C. Edmondson, 2001. "Organizational Differences in Rates of Learning: Evidence from the Adoption of Minimally Invasive Cardiac Surgery," Management Science, INFORMS, vol. 47(6), pages 752-768, June.
    13. David Dranove & Daniel Kessler & Mark McClellan & Mark Satterthwaite, 2003. "Is More Information Better? The Effects of "Report Cards" on Health Care Providers," Journal of Political Economy, University of Chicago Press, vol. 111(3), pages 555-588, June.
    14. Edwin Mansfield, 1963. "The Speed of Response of Firms to New Techniques," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 77(2), pages 290-311.
    15. David M. Cutler & Mark McClellan, 1996. "The Determinants of Technological Change in Heart Attack Treatment," NBER Working Papers 5751, National Bureau of Economic Research, Inc.
    16. Stern, S. & Trajtenberg, M., 1998. "Empirical Implications of Physician Authority in Pharmaceutical Decisionmaking," Papers 24-98, Tel Aviv.
    17. Levin, Sharon G & Levin, Stanford L & Meisel, John B, 1992. "Market Structure, Uncertainty, and Intrafirm Diffusion: The Case of Optical Scanners in Grocery Stores," The Review of Economics and Statistics, MIT Press, vol. 74(2), pages 345-350, May.
    18. Julio J. Rotemberg & Garth Saloner, 1995. "Overt Interfunctional Conflict (and its Reduction Through Business Strategy)," RAND Journal of Economics, The RAND Corporation, vol. 26(4), pages 630-653, Winter.
    19. Timothy H. Hannan & John M. McDowell, 1984. "The Determinants of Technology Adoption: The Case of the Banking Firm," RAND Journal of Economics, The RAND Corporation, vol. 15(3), pages 328-335, Autumn.
    20. Mark McClellan & Douglas Staiger, 1999. "The Quality of Health Care Providers," NBER Working Papers 7327, National Bureau of Economic Research, Inc.
    21. Karlson, Stephen H, 1986. "Adoption of Competing Inventions by United States Steel Producers," The Review of Economics and Statistics, MIT Press, vol. 68(3), pages 415-422, August.
    22. Yip, Winnie C., 1998. "Physician response to Medicare fee reductions: changes in the volume of coronary artery bypass graft (CABG) surgeries in the Medicare and private sectors," Journal of Health Economics, Elsevier, vol. 17(6), pages 675-699, December.
    23. Mas, Núria & Seinfeld, Janice, 2008. "Is managed care restraining the adoption of technology by hospitals?," Journal of Health Economics, Elsevier, vol. 27(4), pages 1026-1045, July.
    24. Abernathy, William J. & Clark, Kim B., 1985. "Innovation: Mapping the winds of creative destruction," Research Policy, Elsevier, vol. 14(1), pages 3-22, February.
    25. Dranove, David, 1988. "Demand Inducement and the Physician/Patient Relationship," Economic Inquiry, Western Economic Association International, vol. 26(2), pages 281-298, April.
    26. Romeo, Anthony A, 1975. "Interindustry and Interfirm Differences in the Rate of Diffusion of an Innovation," The Review of Economics and Statistics, MIT Press, vol. 57(3), pages 311-319, August.
    27. McGuire, Thomas G. & Pauly, Mark V., 1991. "Physician response to fee changes with multiple payers," Journal of Health Economics, Elsevier, vol. 10(4), pages 385-410.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Mary A. Burke & Gary M. Fournier & Kislaya Prasad, 2007. "The Diffusion of a Medical Innovation: Is Success in the Stars?," Southern Economic Journal, John Wiley & Sons, vol. 73(3), pages 588-603, January.
    2. Tinglong Dai & Kelly Gleason & Chao‐Wei Hwang & Patricia Davidson, 2021. "Heart analytics: Analytical modeling of cardiovascular care," Naval Research Logistics (NRL), John Wiley & Sons, vol. 68(1), pages 30-43, February.
    3. Varabyova, Yauheniya & Blankart, Carl Rudolf & Greer, Ann Lennarson & Schreyögg, Jonas, 2017. "The determinants of medical technology adoption in different decisional systems: A systematic literature review," Health Policy, Elsevier, vol. 121(3), pages 230-242.
    4. Diwas Singh KC & Bradley R. Staats, 2012. "Accumulating a Portfolio of Experience: The Effect of Focal and Related Experience on Surgeon Performance," Manufacturing & Service Operations Management, INFORMS, vol. 14(4), pages 618-633, October.
    5. Robert S. Huckman & Gary P. Pisano, 2006. "The Firm Specificity of Individual Performance: Evidence from Cardiac Surgery," Management Science, INFORMS, vol. 52(4), pages 473-488, April.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Battisti, Giuliana & Stoneman, Paul, 2005. "The intra-firm diffusion of new process technologies," International Journal of Industrial Organization, Elsevier, vol. 23(1-2), pages 1-22, February.
    2. Rui Baptista, 1999. "The Diffusion of Process Innovations: A Selective Review," International Journal of the Economics of Business, Taylor & Francis Journals, vol. 6(1), pages 107-129.
    3. Blackman, Allen, 1999. "The Economics of Technology Diffusion: Implications for Climate Policy in Developing Countries," Discussion Papers 10574, Resources for the Future.
    4. Gomez, Jaime & Vargas, Pilar, 2009. "The effect of financial constraints, absorptive capacity and complementarities on the adoption of multiple process technologies," Research Policy, Elsevier, vol. 38(1), pages 106-119, February.
    5. Toshiaki Iizuka, 2007. "Experts' agency problems: evidence from the prescription drug market in Japan," RAND Journal of Economics, RAND Corporation, vol. 38(3), pages 844-862, September.
    6. Fuentelsaz, Lucio & Gomez, Jaime & Polo, Yolanda, 2003. "Intrafirm diffusion of new technologies: an empirical application," Research Policy, Elsevier, vol. 32(4), pages 533-551, April.
    7. Jeffrey S. McCullough, 2008. "The adoption of hospital information systems," Health Economics, John Wiley & Sons, Ltd., vol. 17(5), pages 649-664, May.
    8. Claudia Keser & Claude Montmarquette & Martin Schmidt & Cornelius Schnitzler, 2020. "Custom-made health-care: an experimental investigation," Health Economics Review, Springer, vol. 10(1), pages 1-12, December.
    9. Lien, Hsien-Ming & Albert Ma, Ching-To & McGuire, Thomas G., 2004. "Provider-client interactions and quantity of health care use," Journal of Health Economics, Elsevier, vol. 23(6), pages 1261-1283, November.
    10. Emanuele Giovannetti & Mohsen Hamoudia, 2022. "The interaction between direct and indirect network externalities in the early diffusion of mobile social networking," Eurasian Business Review, Springer;Eurasia Business and Economics Society, vol. 12(4), pages 617-642, December.
    11. Stoneman, Paul & Battisti, Giuliana, 2010. "The Diffusion of New Technology," Handbook of the Economics of Innovation, in: Bronwyn H. Hall & Nathan Rosenberg (ed.), Handbook of the Economics of Innovation, edition 1, volume 2, chapter 0, pages 733-760, Elsevier.
    12. Jalal Akhavein & W. Scott Frame & Lawrence J. White, 2005. "The Diffusion of Financial Innovations: An Examination of the Adoption of Small Business Credit Scoring by Large Banking Organizations," The Journal of Business, University of Chicago Press, vol. 78(2), pages 577-596, March.
    13. Jaffe, Adam B. & Newell, Richard G. & Stavins, Robert N., 2003. "Chapter 11 Technological change and the environment," Handbook of Environmental Economics, in: K. G. Mäler & J. R. Vincent (ed.), Handbook of Environmental Economics, edition 1, volume 1, chapter 11, pages 461-516, Elsevier.
    14. Andrew Epstein & Scott Johnson, 2012. "Physician response to financial incentives when choosing drugs to treat breast cancer," International Journal of Health Economics and Management, Springer, vol. 12(4), pages 285-302, December.
    15. Brant Callaway & Vivek Ghosal, 2012. "Adoption and Diffusion of Health Information Technology - The Case of Primary Care Clinics," CESifo Working Paper Series 3925, CESifo.
    16. Casey Ichniowski & Kathryn Shaw, 1995. "Old Dogs and New Tricks: Determinants of the Adoption of Productivity-Enhancing Work Practices," Brookings Papers on Economic Activity, Economic Studies Program, The Brookings Institution, vol. 26(1995 Micr), pages 1-65.
    17. Erin M. Johnson & M. Marit Rehavi, 2016. "Physicians Treating Physicians: Information and Incentives in Childbirth," American Economic Journal: Economic Policy, American Economic Association, vol. 8(1), pages 115-141, February.
    18. Ming-yuan Chen, 2005. "Technology adoption in response to changes in market conditions: Evidence from the US petroleum refining industry," Economics of Innovation and New Technology, Taylor & Francis Journals, vol. 14(8), pages 735-756.
    19. Currie, Janet & Lin, Wanchuan & Zhang, Wei, 2011. "Patient knowledge and antibiotic abuse: Evidence from an audit study in China," Journal of Health Economics, Elsevier, vol. 30(5), pages 933-949.
    20. Barili, Emilia & Bertoli, Paola & Grembi, Veronica, 2021. "Fee equalization and appropriate health care," Economics & Human Biology, Elsevier, vol. 41(C).

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:inm:ormnsc:v:49:y:2003:i:5:p:599-617. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Chris Asher (email available below). General contact details of provider: https://edirc.repec.org/data/inforea.html .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.