Current reimbursement schemes imply different incentives for health care providers, among whichthere are the ones related to the adoption of technology. Several empirical studies haveinvestigated the links between the pattern of medical technology adoption, particularly medicalequipment, and a few determinant factors, among which reimbursement mechanisms. Most ofthese studies, however, focus on single and specific medical equipment and, therefore, theiranalysis is inherently limited to represent the characteristics of the reimbursement mechanism forthe specific services connected with the use of a given technology, with respect to other services.In this paper, we aim at enlarging the scope of analysis so as to consider the impact of the generalfeatures of reimbursement mechanisms on the adoption of medical technology. Our analysis isfocused on hospital care in Italy. The DRG mechanism was introduced in the early nineties, while,at the same time, regional governments were recognized extended autonomy in the implementationof the payment mechanism (determination of rates, differentiation of the reimbursement system fordifferent providers, etc.). Moreover, these reforms were implemented in a situation characterizedby relevant differences across regions, in terms of technological endowments. Our analysis willfocus on the change in the medical equipment of Italian hospitals in the period 1997-2007. Thedata are available for the overall hospital sector, at a regional level (there are 20 regions in Italy).We build up and indicator for measuring the regional endowment of medical equipment, based ona weighted sum of the number of equipment, where the weights are represented by a vector ofnormalized prices. The main objective of the analysis is to check how the differences across theregional reimbursement mechanisms, above all in terms of how extended is the use of the DRGsystem in the coverage of the overall financing of hospital care, impact on the change in the equipment endowment, as measured by our indicator.
Hospital care reimbursement mechanisms and the adoption of medical technology in the Italian NHS
GUCCIO C.;PIGNATARO G.;RIZZO I.
2011-01-01
Abstract
Current reimbursement schemes imply different incentives for health care providers, among whichthere are the ones related to the adoption of technology. Several empirical studies haveinvestigated the links between the pattern of medical technology adoption, particularly medicalequipment, and a few determinant factors, among which reimbursement mechanisms. Most ofthese studies, however, focus on single and specific medical equipment and, therefore, theiranalysis is inherently limited to represent the characteristics of the reimbursement mechanism forthe specific services connected with the use of a given technology, with respect to other services.In this paper, we aim at enlarging the scope of analysis so as to consider the impact of the generalfeatures of reimbursement mechanisms on the adoption of medical technology. Our analysis isfocused on hospital care in Italy. The DRG mechanism was introduced in the early nineties, while,at the same time, regional governments were recognized extended autonomy in the implementationof the payment mechanism (determination of rates, differentiation of the reimbursement system fordifferent providers, etc.). Moreover, these reforms were implemented in a situation characterizedby relevant differences across regions, in terms of technological endowments. Our analysis willfocus on the change in the medical equipment of Italian hospitals in the period 1997-2007. Thedata are available for the overall hospital sector, at a regional level (there are 20 regions in Italy).We build up and indicator for measuring the regional endowment of medical equipment, based ona weighted sum of the number of equipment, where the weights are represented by a vector ofnormalized prices. The main objective of the analysis is to check how the differences across theregional reimbursement mechanisms, above all in terms of how extended is the use of the DRGsystem in the coverage of the overall financing of hospital care, impact on the change in the equipment endowment, as measured by our indicator.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
