Technological Change Around The World: Evidence From Heart Attack Care

"Supply side" incentives to curtail health care spending are closely linked with trends in the use of costly treatments. by the Technological Change in Health Care (TECH) Research Network ABSTRACT: Although technological change is a hallmark of health care worldwide , relatively little evidence exists on whether changes in health care differ across the very different health care systems of developed countries. We present new comparative evidence on heart attack care in seventeen countries showing that technological change-changes in medical treatments that affect the quality and cost of care-is universal but has differed greatly around the world. Differences in treatment rates are greatest for costly medical technologies , where strict financing limits and other policies to restrict adoption of intensive technologies have been associated with divergences in medical practices over time. Countries appear to differ systematically in the time at which intensive cardiac procedures began to be widely used and in the rate of growth of the procedures. The differences appear to be related to economic and regulatory incentives of the health care systems and may have important economic and health consequences. H ea lt h c ar e is an i ndu st ry that is becoming part of a global economy. Biomedical knowledge and technologies are already "global" in the sense that leading physicians in all developed countries read the same journals and electronic reviews and participate in international consortia to encourage best practices. For the most part, the same drugs and devices are available worldwide, at least within a few years of each other. Leading clinical researchers and experts collaborate internationally; leading drug and biotechnology firms think globally. As worldwide policy interest in quality of care continues to rise, international comparisons of health care systems are becoming common. Yet health care also remains a local industry, with care delivered by physicians influenced by their local peers, practice settings, and health care policies.