Hostname: page-component-78c5997874-ndw9j Total loading time: 0 Render date: 2024-11-10T17:08:20.171Z Has data issue: false hasContentIssue false

The Effects of Health Insurance on Access to New Medical Technologies

Published online by Cambridge University Press:  10 March 2009

Scott D. Ramsey
Affiliation:
University of Washington
Alan L. Hillman
Affiliation:
University of Pennsylvania
Mark V. Pauly
Affiliation:
University of Pennsylvania

Abstract

We examined the use of percutaneous transluminal coronary angioplasty, kidney stone lithotripsy, and bone marrow transplant among patients with different health insurance plans in California. HMO enrollees were less likely to receive these procedures compared with fee-for-service patients. Our results have implications for the inflationary effects of technology under managed care.

Type
General Essays
Copyright
Copyright © Cambridge University Press 1997

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

1.Baumgardner, J.The interaction between forms of insurance contract and types of technical change in medical care. Journal of Economics, 1991, 22, 3653.Google ScholarPubMed
2.DesHarnais, S., Hogan, A. J., Chesney, J., et al. The Risk-Adjusted Mortality Index: A new measure of hosptial performance. Ann Arbor, MI: Commission on Professional and Hospital Activities, 05, 1988.CrossRefGoogle Scholar
3.DesHarnais, S., McMahon, L. F., & Wroblewski, R.Measuring outcomes of hospital care using multiple risk-adjusted indexes. Health Services Research, 1991, 26, 425–45.Google ScholarPubMed
4.DesHarnais, S. I., McMahon, L. F., Wroblewski, R. T., & Hogan, A. J.Measuring hospital performance: The development and validation of risk-adjusted indexes of mortality, readmissions, and complications. Medical Care, 1990, 28, 1127–41.CrossRefGoogle ScholarPubMed
5.Fuchs, V. R., & Garber, A. M.The new technology assessment. New England Journal of Medicine, 1990, 323, 673–77.CrossRefGoogle ScholarPubMed
6.Gabel, J., Jajich-Toth, C., Lissovoy, G., et al. The changing world of group health insurance. Health Affairs, 1994, 7, 4865.CrossRefGoogle Scholar
7.Garber, A. M.No price too high? New England Journal of Medicine, 1992, 327, 1676–78.CrossRefGoogle Scholar
8.Goddeeris, J. H., & Weisbrod, B. A.What we don't know about why health care expenditures have soared: Interaction of insurance and technology. Mount Sinai Journal of Medicine, 1985, 52, 685–91.Google ScholarPubMed
9.Guterman, S., & Dobson, A.Impact of Medicare prospective payment system for hospitals. Health Care Financing Review, 1984, 7, 275–96.Google Scholar
10.Iezzoni, L. I., Ash, A. S., Coffman, G. A., & Moskowitz, M. A.Predicting in-hospital mortality: A comparison of severity measurement approaches. Medical Care, 1992, 30, 347–59.CrossRefGoogle ScholarPubMed
11.Jackson-Beeck, M.,& Kleinman, J.Evidence for self selection among health maintenance organization enrollees. Journal of the American Medical Association, 1983, 250, 2826–29.CrossRefGoogle ScholarPubMed
12.Langa, K. M., & Sussman, E. J.The effect of cost-containment policies on rates of coronary revascularization in California. New England Journal of Medicine, 1993, 329, 1784–89.CrossRefGoogle ScholarPubMed
13.Lubitz, J. D., Gornick, M. E., Mentneck, R. M., & Loop, F. D.Rehospitalization after coronary revascularization among Medicare beneficiaries. American Journal of Cardiology, 1993, 72, 2630.CrossRefGoogle ScholarPubMed
14.Luft, H. S.Trends in medical care costs: Do HMO's lower the rate of growth? Medical Care, 1980, 18, 116.CrossRefGoogle Scholar
15.Luft, H. S., Health maintenance organizations: Dimensions of performance. New York: John Wiley and Sons, 1981.Google Scholar
16.Manning, W. G., Newhouse, J. P., & Duan, N., et al. Health insurance and the demand for medical care: Evidence from a randomized experiment. American Economic Review, 1987, 77, 251–77.Google ScholarPubMed
17.Merril, J., Jackson, C., & Reuter, J.Factors that affect the HMO enrollment decision: A tale of two cities. Inquiry, 1985, 22, 388–95.Google Scholar
18.Miller, L. H., & Luft, H. S.Managed care performance since 1980: A literature analysis. Journal of the American Medical Association, 1994, 271, 1512–19.CrossRefGoogle ScholarPubMed
19.Newhouse, J. P., Schwartz, W. B., & Williams, A. P., et al. Are fee-for-service costs increasing faster than HMO costs? Medical Care, 1985, 23, 960–66.CrossRefGoogle ScholarPubMed
20.Ramsey, S. D., & Pauly, M. V. Health insurance effects on the adoption and utilization of new medical technologies. Presented at the National Bureau of Economic Research conference on medical technology, 09, 1994.Google Scholar
21.Russell, L. B.Technology in hospitals. Washington, DC: Brookings Institution, 1979.CrossRefGoogle Scholar
22.Short, P. F., & Taylor, A. K.Premiums, benefits, and employee choice of health insurance options. Journal of Health Economics, 1989, 8, 293311.CrossRefGoogle ScholarPubMed
23.Sloan, F. A., Valvona, F., Perrin, J. M., & Adamache, K. W.Diffusion of surgical technology: An exploratory study. Journal of Health Economics, 1986, 5, 3161.CrossRefGoogle ScholarPubMed
24.U.S. Congress, Office of Technology Assessment. Assessing the efficacy and safety of medical technologies. Washington, DC: Government Printing Office, 1978.Google Scholar
25.Welch, W. P.Health care utilization in HMO's: Results from two national samples. Journal of Health Economics, 1985, 4, 293308.CrossRefGoogle ScholarPubMed
26.Whittle, J., Conigliaro, J., Good, C. B., & Lofgren, R. P.Racial differences in the use of invasive cardiovascular procedures in the Department of Veterans Affairs medical system. New England Journal of Medicine, 1993, 329, 621–27.CrossRefGoogle ScholarPubMed