GLOBAL ANALYSIS OF TECHNOLOGICAL CHANGE IN HEALTH CARE

医疗保健技术变革的全球分析

• 批准号: 2848593
• 负责人: MARK B MCCLELLAN
• 金额: $ 17.54万
• 依托单位: STANFORD UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 1999
• 资助国家: 美国
• 起止时间: 1999-07-01 至 2003-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/2848593
• 关键词: aging; behavioral /social science research tag; data collection methodology /evaluation; epidemiology; geographic site; health care cost /financing; health care policy; health care service; health economics; health services research tag; human data; interdisciplinary collaboration; international cooperation; longitudinal human study; myocardial infarction; myocardial ischemia /hypoxia; outcomes research; technology /technique

Relatively little is known about differences across countries in changes in medical technology, and the potentially important dynamic implications of these differences for changes in medical expenditures and health outcomes. We will develop a collaborative, global research network to analyze technological change at the "micro" level. We will begin with an analysis of changes in heart attach care, an important health problem for aging populations worldwide, and will gradually expand this focused analysis. Our study has three specific aims: 1. To develop a sustainable global network of collaborating health care researchers with expertise in clinical medicine, economics, epidemiology, and related fields, able to conduct detailed, valid studies with comparable microdata and standardized methods. 2. To conduct a detailed, quantitative analysis of technological change in the treatment of heart attacks in the participating countries, resulting in a series of publications that describe and quantify in detail how technological change for this disease has differed across countries, the economical and regulatory factors influencing these treatment differences, and their consequences for disease outcomes and resource use. 3. To generalize these results, by (a) extending our methods to study the more prevalent but less severe forms of ischemic heart disease, (b) relating our disease-specific, "micro" findings to existing evidence on aggregate "macro" differences in the levels and trends in medical expenditures and health outcomes across countries, and (c) conducting exploratory studies to extend our methods to the analysis of a more chronic illness. Our longitudinal approach and our initial emphasis on a cure, severe illness are likely to make it easier for us to isolate the effects of medical technology from many important but (relatively) stable cross- country differences that confound cross-sectional and "macro" studies. We have conducted extensive preliminary studies to explore the feasibility of this collaborative approach, and their encouraging results have led to this proposal to support the coordination of an international research network on technological change in health care.

相对而言，人们对各国在医疗技术变化方面的差异以及这些差异对医疗支出和健康结果变化的潜在重要动态影响知之甚少。我们将建立一个协作的全球研究网络，从“微观”层面分析技术变革。我们将首先分析心脏附加护理的变化，这是全球老龄化人口的一个重要健康问题，并将逐步扩大这一重点分析。我们的研究有三个具体目的：1。发展具有临床医学、经济学、流行病学和相关领域专业知识的卫生保健研究人员合作的可持续全球网络，能够用可比的微数据和标准化方法进行详细、有效的研究。2. 对参与国治疗心脏病的技术变革进行详细的定量分析，发表一系列出版物，详细描述和量化各国治疗这种疾病的技术变革有何不同，影响这些治疗差异的经济和监管因素，以及它们对疾病结局和资源使用的影响。3. 为了概括这些结果，(a)将我们的方法扩展到研究更普遍但不太严重的缺血性心脏病形式，(b)将我们的疾病特异性“微观”发现与各国医疗支出和健康结果水平和趋势的总体“宏观”差异的现有证据联系起来，(c)进行探索性研究，将我们的方法扩展到分析更慢性的疾病。我们的纵向方法和我们最初强调的治愈，严重的疾病可能使我们更容易将医疗技术的影响从许多重要但（相对）稳定的跨国差异中分离出来，这些差异混淆了横断面和“宏观”研究。我们进行了广泛的初步研究，以探讨这种合作办法的可行性，其令人鼓舞的结果促使我们提出这一建议，以支持协调一个关于保健技术变革的国际研究网络。