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Investigating Regional Variation of Cardiac Implantable Electrical Device Implant Rates in European Healthcare Systems: What Drives Differences?

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  • Aleksandra Torbica
  • Helen Banks
  • Cinzia Valzania
  • Giuseppe Boriani
  • Giovanni Fattore

Abstract

Despite established efficacy for cardiac implantable electrical devices (CIEDs), large differences in CIED implant rates have been documented across and within countries. The aim of this paper is to investigate the influence of socio‐economic, epidemiological and supply side factors on CIED implant rates across 57 Regions in 5 EU countries and to assess the feasibility of using administrative data for this purpose. A total of 1 330 098 hospitalizations for CIED procedures extracted from hospital discharge databases in Austria, England, Germany, Italy and Slovenia from 2008 to 2012 was used in the analysis. Higher levels of tertiary education among the labour force and percent of aged population are positively associated with implant rates of CIED. Regional per capita GDP and number of implanting centres appear to have no significant effect. Institutional factors are shown to be important for the diffusion of CIED. Wide variation in CIED implant rates across and within five EU countries is undeniable. However, regional factors play a limited part in explaining these differences with few exceptions. Administrative databases are a valuable source of data for investigating the diffusion of medical technologies, while the choice of appropriate modelling strategy is crucial in identifying the drivers for variation across countries. © 2017 The Authors. Health Economics published by John Wiley & Sons, Ltd.

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  • Aleksandra Torbica & Helen Banks & Cinzia Valzania & Giuseppe Boriani & Giovanni Fattore, 2017. "Investigating Regional Variation of Cardiac Implantable Electrical Device Implant Rates in European Healthcare Systems: What Drives Differences?," Health Economics, John Wiley & Sons, Ltd., vol. 26(S1), pages 30-45, February.
    • Handle: RePEc:wly:hlthec:v:26:y:2017:i:s1:p:30-45
    DOI: 10.1002/hec.3470
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    References listed on IDEAS

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    3. Valzania, Cinzia & Torbica, Aleksandra & Tarricone, Rosanna & Leyva, Francisco & Boriani, Giuseppe, 2016. "Implant rates of cardiac implantable electrical devices in Europe: A systematic literature review," Health Policy, Elsevier, vol. 120(1), pages 1-15.
    4. Terkel Christiansen & Kelly Dunham & Jørgen Lauridsen & Carl Hampus Lyttkens & Kathryn Mcdonald & Alistair Mcguire & Carine Milcent, 2009. "The influence of economic incentives and regulatory factors on the adoption of treatment technologies: a case study of technologies used to treat heart attacks," Post-Print halshs-03168477, HAL.
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    1. Rosanna Tarricone & Aleksandra Torbica & Michael Drummond, 2017. "Challenges in the Assessment of Medical Devices: The MedtecHTA Project," Health Economics, John Wiley & Sons, Ltd., vol. 26(S1), pages 5-12, February.
    2. Stefan Rabbe & Meilin Möllenkamp & Benedetta Pongiglione & Hedwig Blommestein & Pim Wetzelaer & Renaud Heine & Jonas Schreyögg, 2022. "Variation in the utilization of medical devices across Germany, Italy, and the Netherlands: A multilevel approach," Health Economics, John Wiley & Sons, Ltd., vol. 31(S1), pages 135-156, September.
    3. Meilin Möllenkamp & Benedetta Pongiglione & Stefan Rabbe & Aleksandra Torbica & Jonas Schreyögg, 2022. "Spillover effects and other determinants of medical device uptake in the presence of a medical guideline: An analysis of drug‐eluting stents in Germany and Italy," Health Economics, John Wiley & Sons, Ltd., vol. 31(S1), pages 157-178, September.
    4. Rosanna Tarricone & Aleksandra Torbica & Michael Drummond & for the MedtecHTA Project Group, 2017. "Key Recommendations from the MedtecHTA Project," Health Economics, John Wiley & Sons, Ltd., vol. 26(S1), pages 145-152, February.

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