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Adoption of large-scale medical equipment: the impact of competition in the German inpatient sector

Author

Listed:
  • Marie Dreger

    (Technische Universität Berlin
    Technische Universität Berlin)

  • Hauke Langhoff

    (Technische Universität Berlin
    Technische Universität Berlin)

  • Cornelia Henschke

    (Technische Universität Berlin
    Technische Universität Berlin
    Brandenburgische Technische Universität Cottbus-Senftenberg)

Abstract

The availability of large-scale medical equipment such as computed tomography (CT), magnet resonance imaging (MRI) and positron emission tomography (PET) scanners has increased rapidly worldwide over the last decades. Among OECD countries, Germany ranks high according to the number of imaging technologies and their applications per inhabitant. In contrast to other countries, there is no active governmental planning of large-scale medical equipment. We therefore investigated whether and how the adoption and distribution of CT, MRI and PET scanners in the German inpatient sector is subject to competition. Using a linear-probability model, we additionally examined the impact of regional, hospital- and population-based factors. In summary, our results indicate that the adoption rate by hospital sites decreases with the number of other sites being already equipped with the respective device and their proximity. However, the effect presumably depends on the technologies’ stage within the diffusion process. No influence regarding the amount of state subsidies could be identified. Furthermore, hospital size and university status strongly affect the adoption.

Suggested Citation

  • Marie Dreger & Hauke Langhoff & Cornelia Henschke, 2022. "Adoption of large-scale medical equipment: the impact of competition in the German inpatient sector," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 23(5), pages 791-805, July.
    • Handle: RePEc:spr:eujhec:v:23:y:2022:i:5:d:10.1007_s10198-021-01395-w
    DOI: 10.1007/s10198-021-01395-w
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    1. Sloan, Frank A. & Valvona, Joseph & Perrin, James M. & Adamache, Killard W., 1986. "Diffusion of surgical technology : An exploratory study," Journal of Health Economics, Elsevier, vol. 5(1), pages 31-61, March.
    2. Guillermo A. Sandoval & Adalsteinn D. Brown & Walter P. Wodchis & Geoffrey M. Anderson, 2018. "Adoption of high technology medical imaging and hospital quality and efficiency: Towards a conceptual framework," International Journal of Health Planning and Management, Wiley Blackwell, vol. 33(3), pages 843-860, July.
    3. Baier, Natalie & Sax, Lisa-Marie & Sundmacher, Leonie, 2019. "Trends and regional variation in rates of orthopaedic surgery in Germany: the impact of competition," Munich Reprints in Economics 78239, University of Munich, Department of Economics.
    4. Gaynor, Martin & Town, Robert J., 2011. "Competition in Health Care Markets," Handbook of Health Economics, in: Mark V. Pauly & Thomas G. Mcguire & Pedro P. Barros (ed.), Handbook of Health Economics, volume 2, chapter 0, pages 499-637, Elsevier.
    5. Natalie Baier & Lisa-Marie Sax & Leonie Sundmacher, 2019. "Trends and regional variation in rates of orthopaedic surgery in Germany: the impact of competition," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 20(1), pages 163-174, February.
    6. Emma Medin & Kjartan Anthun & Unto Häkkinen & Sverre Kittelsen & Miika Linna & Jon Magnussen & Kim Olsen & Clas Rehnberg, 2011. "Cost efficiency of university hospitals in the Nordic countries: a cross-country analysis," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 12(6), pages 509-519, December.
    7. Robinson, James C. & Luft, Harold S., 1985. "The impact of hospital market structure on patient volume, average length of stay, and the cost of care," Journal of Health Economics, Elsevier, vol. 4(4), pages 333-356, December.
    8. Zahra Abedini & Ali Akbari Sari & Abbas Rahimi Foroushani & Ebrahim Jaafaripooyan, 2019. "Diffusion of advanced medical imaging technology, CT, and MRI scanners, in Iran: A qualitative study of determinants," International Journal of Health Planning and Management, Wiley Blackwell, vol. 34(1), pages 397-410, January.
    9. Davis, Karen & Russell, Louise B, 1972. "The Substitution of Hospital Outpatient Care for Inpatient Care," The Review of Economics and Statistics, MIT Press, vol. 54(2), pages 109-120, May.
    10. Andrew Bell & Malcolm Fairbrother & Kelvyn Jones, 2019. "Fixed and random effects models: making an informed choice," Quality & Quantity: International Journal of Methodology, Springer, vol. 53(2), pages 1051-1074, March.
    11. White, Halbert, 1980. "A Heteroskedasticity-Consistent Covariance Matrix Estimator and a Direct Test for Heteroskedasticity," Econometrica, Econometric Society, vol. 48(4), pages 817-838, May.
    12. Sophia Rabe-Hesketh & Anders Skrondal, 2012. "Multilevel and Longitudinal Modeling Using Stata, 3rd Edition," Stata Press books, StataCorp LP, edition 3, number mimus2.
    13. Jeffrey M Wooldridge, 2010. "Econometric Analysis of Cross Section and Panel Data," MIT Press Books, The MIT Press, edition 2, volume 1, number 0262232588, December.
    14. Augurzky, Boris & Dördelmann, Sandra & Pilny, Adam, 2016. "Überblick Krankenhausstrukturen Rheinland-Pfalz und Saarland," RWI Projektberichte, RWI - Leibniz-Institut für Wirtschaftsforschung, number 149878.
    15. Frank M. Bass, 1969. "A New Product Growth for Model Consumer Durables," Management Science, INFORMS, vol. 15(5), pages 215-227, January.
    16. Augurzky, Boris & Pilny, Adam & Wübker, Ansgar, 2015. "Krankenhäuser in privater Trägerschaft 2015," RWI Materialien 89, RWI - Leibniz-Institut für Wirtschaftsforschung.
    17. Coenen, Michael & Haucap, Justus & Herr, Annika, 2011. "Regionalität: Wettbewerbliche Überlegungen zum Krankenhausmarkt," DICE Ordnungspolitische Perspektiven 13, Heinrich Heine University Düsseldorf, Düsseldorf Institute for Competition Economics (DICE).
    18. Pedro Pita Barros & Werner B. F. Brouwer & Sarah Thomson & Marco Varkevisser, 2016. "Competition among health care providers: helpful or harmful?," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 17(3), pages 229-233, April.
    19. Patricia Ex & Cornelia Henschke, 2019. "Changing payment instruments and the utilisation of new medical technologies," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 20(7), pages 1029-1039, September.
    20. Schmid, Andreas & Ulrich, Volker, 2013. "Consolidation and concentration in the German hospital market: The two sides of the coin," Health Policy, Elsevier, vol. 109(3), pages 301-310.
    21. Michael Berger & Thomas Czypionka, 2021. "Regional medical practice variation in high-cost healthcare services," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 22(6), pages 917-929, August.
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