Document Detail


Does advanced medical technology encourage hospitalist use and their direct employment by hospitals?
MedLine Citation:
PMID:  18470953     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
In the United States, inpatient medical care increasingly encompasses the use of expensive medical technology and, at the same time, is coordinated and supervised more and more by a rapidly growing number of inpatient-dedicated physicians (hospitalists). In the production of inpatient care services, Hospitalist services can be viewed as complementary to sophisticated and expensive medical equipment in the provision of inpatient medical care. We investigate the causal relationship between a hospital's access to three types of sophisticated diagnostic and therapeutic medical equipment - intensity-modulated radiation therapy, gamma knife, and multi-slice computed tomography - and its likelihood of using hospitalists. To rule out omitted variables bias and reverse causality, we use technology-specific Certificate of Need regulation to predict technology use. We find a strong positive association, yet no causal link between access to medical technology and hospitalist use. We also study the choice of employment modality among hospitals that use hospitalists, and find that access to expensive medical technology reduces the hospital's propensity to employ hospitalists directly.
Authors:
Guy David; Lorens A Helmchen; Robert A Henderson
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Health economics     Volume:  18     ISSN:  1057-9230     ISO Abbreviation:  Health Econ     Publication Date:  2009 Feb 
Date Detail:
Created Date:  2009-01-15     Completed Date:  2009-02-25     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9306780     Medline TA:  Health Econ     Country:  England    
Other Details:
Languages:  eng     Pagination:  237-47     Citation Subset:  IM    
Copyright Information:
Copyright (c) 2008 John Wiley & Sons, Ltd.
Affiliation:
The Wharton School, University of Pennsylvania, Philadelphia, PA, USA. gdavid2@wharton.upenn.edu
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MeSH Terms
Descriptor/Qualifier:
American Hospital Association
Biomedical Technology / economics,  trends*
Causality
Certificate of Need / statistics & numerical data*
Contract Services / economics,  utilization
Coronary Angiography / statistics & numerical data
Diffusion of Innovation
Employment / classification,  statistics & numerical data*
Health Care Surveys
Hospitalists / economics,  statistics & numerical data*
Humans
Institutional Practice
Probability
Questionnaires
Radiosurgery / statistics & numerical data
Radiotherapy, Intensity-Modulated / statistics & numerical data
Technology, High-Cost / economics,  utilization*
United States
Utilization Review*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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