This thesis examines technology diffusion within the UK NHS. Motivated by increasing health expenditure over the last years, it is important to understand the diffusion process of medical technology in order to determine the factors that enhance or delay the incorporation of technologies into common practice. Given the uncertainty inherent in new technology and its presupposed competitive advantage, the diffusion process is approached through the informational sources available to agents as a mechanism to overcome uncertainty. Information increases physicians' knowledge on product quality and consequently influences technology choice. The set of regulatory and financial incentives provided by the health care system are also considered. Throughout the thesis dynamic panel data methods are used to estimate technology demand equations. The first case study looks at diffusion within the primary care sector of three drug groups at the therapeutical class level using prescription data from IMS Health. The second empirical case explores within-group therapeutical diffusion with emphasis on competition amongst branded products. The question addressed relates to the informational and product characteristics that consolidate different prescription trends and product uptake. Results suggest that prescription experience is the most important source of information; however, physicians access additional informative channels when the technology is a breakthrough innovation. Additionally, drug diffusion is unaffected by the health system organisation. The final empirical work addresses diffusion of two surgical procedures in the secondary care sector using HES data. Specifically, it considers the impact of competition introduced by the NHS reforms initiated in the 90s. Patient follow-up also allows exploration of the impact that surgical innovation has on patients' health outcomes using a competing risk model. Findings suggest higher diffusion in less concentrated markets, with specialised and university providers having faster uptake. Moreover, diffusion presents long-term effects on improved quality of care.
| Identifer | oai:union.ndltd.org:bl.uk/oai:ethos.bl.uk:645795 |
| Date | January 2008 |
| Creators | Serra-Sastre, Victoria |
| Publisher | London School of Economics and Political Science (University of London) |
| Source Sets | Ethos UK |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
| Source | http://etheses.lse.ac.uk/2990/ |
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