Abstract
Technological progress in medicine is remarkable. However, advanced interventional and diagnostic technologies cannot improve health outcomes unless they are effectively applied. Efficacy of these technologies is examined by clinical trials, but it is not clear how much they actually contribute to better outcomes in day-to-day practice. This paper investigates the extent to which its efficacy is affected by factors specific to each hospital, by utilizing random coefficient models.
Medical literature demonstrates that using stents improves long-term outcomes such as revascularization, although its short-term outcomes are not different than those of plain PTCA. This paper shows that the efficacy of stenting differs significantly across hospitals. Some hospitals effectively utilize stents while others negate its efficacy by inappropriate applications. Also, the efficacy of rotational atherectomy and intravascular ultrasound is found to vary significantly across hospitals.
Our results show that what is of urgent importance is not the introduction itself of advanced technologies, but the establishment of systems which enable such technologies to effectively contribute to improvements in health outcomes.
