Technology in American Health Care is a comprehensive, multidisciplinary guide to understanding how medical advances -- new drugs, biological devices, and surgical procedures -- are developed, brought to market, evaluated, and adopted into health care.
Cost-effective delivery of evidence-based health care is the sine qua non of American medicine in the twenty-first century. Health care decision makers, providers, payers, policymakers, and consumers all need vital information about the risks, benefits, and costs of new technologies in order to make informed decisions about which ones to adopt and how to use them. Alan B. Cohen and Ruth S. Hanft explore the evolving field of medical technology evaluation (MTE), as well as the current controversies surrounding the evaluation and diffusion of medical technologies, including the methods employed in their assessment and the policies that govern their adoption and use.
The book opens with an introduction that provides basic definitions and the history of technological change in American medicine, and a second chapter that explores critical questions regarding medical technology in health care. Part I discusses biomedical innovation, the development and diffusion of medical technology, and the adoption and use of technology by hospitals, physicians, and other health care organizations and professions under changing health care market conditions. Part II examines the methods of MTE -- including randomized controlled trials, meta-analyses, economic evaluation methods (such as cost-benefit, cost-effectiveness, and cost-utility analyses), and clinical decision analysis. Part III focuses on key public policy issues and concerns that affect the organization, financing, and delivery of health care and that relate importantly to medical technology, including safety, efficacy, quality, cost, access, equity, social, ethical, legal, and evaluation concerns.
All three parts of the book provide a historical perspective on the relevant issues, methods, and policy concerns and contain examples of technologies whose development, adoption, evaluation, and use have contributed to our understanding of the field.
This book will be invaluable in making MTE more accessible to individuals who are directly involved in the evaluation process and those who are touched by it in their professional lives -- policymakers, clinicians, managers, and researchers.
Alan B. Cohen is Professor of Health Policy and Management and Executive Director of the Boston University Health Policy Institute. He also directs the national program office of the Robert Wood Johnson Foundation's Scholars in Health Policy Research program. His research has focused on medical technology adoption, cost containment and health policy, comparative health care systems, and the evaluation of health care programs.
Ruth S. Hanft is currently Adjunct Associate in the Center for Bioethics at the University of Virginia and at Dartmouth Medical School and a member of the Institute of Medicine, National Academy of Sciences. She specializes in health services administration and public finance. Dr. Hanft is a former Department of Health and Human Services Deputy Assistant Secretary for Health Research, and, more recently, Professor in the George Washington University Department of Health Services Management and Policy.