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Medical innovation and changes in practice patterns.
(Archived Project)
Investigator (PI): Chernew, Michael E
Performing Organization (PO): (Current): University of Michigan, School of Public Health
Supporting Agency (SA): Agency for Healthcare Research and Quality (AHRQ)
Initial Year: 1998
Final Year: 2001
Record Source/Award ID: CRISP/R03HS09838
Funding: Total Award Amount: $76,178
Award Type: Grant
Abstract: 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 diffuses. 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.
MeSH Terms:
  • Coronary Disease /economics
  • /*therapy
  • * Diffusion of Innovation
  • Fee-for-Service Plans
  • Health Care Costs /trends
  • Health Expenditures /trends
  • Health Maintenance Organizations /*economics
  • /trends
  • Health Services
  • Humans
  • United States
Keywords:
  • 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
  • research support, U.S. Gov't, P.H.S.
Country: United States
State: Michigan
Zip Code: 97201
UI: 98400530
Project Status: Archived