How do Hospitals Adopt Advanced Treatment Techniques? An assessment through the records of AMI patients in Japan

For better clinical outcomes in hospitals, some advanced but costly techniques are often required. Facing these trade-offs of cost and quality, hospitals decide when and what techniques to apply. This paper investigates the spread of some advanced materials, mechanical devices, or procedures for acute myocardial infarction (AMI) through 11,120 patients' records in 92 hospitals in Japan. Since the daily cost of hospital services is fixed under a nationwide health insurance policy, we can assume almost uniform revenue constraints for treatment. The decisions of hospitals therefore are worth comparing. We measure the hospitals' propensities to adopt technologies and compare these with hospital-level mortality of AMI. In addition, we argue whether the spread of technical progress can be explained by geography (distance between the hospitals), or by governance under a hospital group. First, the results show that the propensities to adopt the advanced techniques vary greatly among hospitals, and these varieties explain hospital-level mortalities. Second, the physical distance between hospitals show a negative correlation to the spread of the same techniques. Finally, we observe similar decision patterns for hospitals under the same health care group.