Dartmouth-Hitchcock Medical Center
One Medical Center Dr.
Institutional Affiliation: Dartmouth College
NBER Working Papers and Publications
|June 2014||The Diffusion of New Medical Technology: The Case of Drug-Eluting Stents|
with Amitabh Chandra, Jonathan Skinner
in Discoveries in the Economics of Aging, David A. Wise, editor
There is considerable variation across hospitals and regions in the diffusion of new medical technologies. Before 2003, bare-metal stents were used by cardiologists seeking to perform revascularization for blockages in the heart. In April of 2003, the FDA approved the use of coated anti-proliferative but more expensive drug-eluting stents, designed to reduce re-narrowing of the artery at the location of the original stent. Adoption was rapid but uneven; in the year following their introduction, drug-eluting stents comprised 83% of total stents among Medicare enrollees in the top quintile of hospitals, but just 33% in the low quintile hospitals. We used the Medicare claims data to test several models of diffusion, and found empirical support for models of expertise (better quality hospitals...