MEDICAL INNOVATION AND CHANGES IN PRACTICE PATTERNS

医疗创新和实践模式的变化

• 批准号: 2827059
• 负责人: MICHAEL E CHERNEW
• 金额: $ 7.62万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 1998
• 资助国家: 美国
• 起止时间: 1998-08-01 至 2001-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/2827059
• 关键词: coronary artery; coronary disorder; health care cost /financing; health care professional practice; health care service evaluation; health care service organization; health care service utilization; health services research tag; human subject; interview; managed care

The goal of this research is to identify the managed care mechanisms that influence the changes in practice patterns associated with medical innovation. The existing literature suggests that the adoption and diffusion of medical innovations is the primary cause of rising health care expenditures. Therefore, understanding whether managed care is likely to alter permanently the underlying trends in health care cost growth requires understanding how managed care influences the process by which medical innovations are integrated into the delivery of health care services. We focus on changes in treatment patterns between 1994 and 1997 for patients with coronary artery disease (CAD) in four diverse delivery systems. These delivery systems include a fee-for-service plan, an IPA model HMO, and two mixed model HMOs, each comprised of a group/staff system and a system resembling a network model HMO. collectively they enroll over three million individuals. This project has three specific aims: 1. To identify factors that have contributed to changes in practice patterns for CAD patients and assess the role that technology has played in causing those changes. 2. To identify the attributes of the organization that may affect the extent to which practice patterns change over time and the rate at which new technology diffuese. 3. To identify and assess the strategies that organizations have pursued specifically aimed at influencing CAD related practice patterns, including those aimed at controlling diffusion of CAD related innovations. The research will be based on semi-structures interviews of physicians (generalists and specialists), administrators of medical groups, and plan administrators and will be guided by the results of an ongoing study measuring practice patterns changes for CAD related services.

本研究的目标是确定管理式医疗机制 影响与医疗相关的实践模式的变化 创新。 现有文献表明，采用和 医疗创新的传播是健康水平提高的主要原因 护理支出。因此，了解管理式医疗是否是 可能会永久改变医疗保健成本的基本趋势 增长需要了解管理式医疗如何影响流程 将医疗创新融入到健康服务中 护理服务。 我们重点关注 1994 年至 1997 年间治疗模式的变化 冠状动脉疾病 (CAD) 患者的四种不同分娩方式 系统。 这些交付系统包括按服务付费计划、IPA 模型 HMO，以及两个混合模型 HMO，每个由一个小组/员工组成 系统和类似于网络模型 HMO 的系统。他们集体 注册人数超过三百万。 该项目具体有三项 目标： 1. 找出导致变化的因素 CAD 患者的实践模式并评估技术的作用 造成了这些变化。 2. 识别属性 可能影响实践模式程度的组织 随着时间的推移以及新技术传播的速度而变化。 3. 到 确定并评估组织所采取的战略 专门旨在影响 CAD 相关实践模式， 包括旨在控制 CAD 相关扩散的措施 创新。 该研究将基于对医生的半结构访谈 （全科医生和专科医生）、医疗团体的管理人员，以及 计划管理者并将以持续的结果为指导 研究测量 CAD 相关服务的实践模式变化。

项目成果

Barriers to constraining health care cost growth.

限制医疗保健成本增长的障碍。

• DOI: 10.1377/hlthaff.23.6.122
• 发表时间: 2004
• 期刊: Health affairs (Project Hope)
• 作者: Chernew,MichaelE;Jacobson,PeterD;Hofer,TimothyP;Aaronson,KeithD;Fendrick,AMark
• 通讯作者: Fendrick,AMark