The Issue
How do technological changes, or changes in medical treatments that affect the quality and costs of care, play out in different health care systems across the world? In this Commonwealth Fund–supported study, researchers set out to investigate this issue by comparing heart attack treatments in 17 nations.
What the Study Found
Medical treatments for heart attacks have become more intensive across developed nations in the past decade. However, there are differences among countries in terms of the point at which invasive cardiac procedures were begun, and in the rate of growth of such procedures. In the United States, new treatments such as catheterization were adopted early and their rate of use grew rapidly, leading to much higher treatment rates. In Canada and Australia, adoption of new treatments took place later than in the U.S., but was followed by similarly fast rate of growth. By contrast, Scandinavian countries and the United Kingdom adopted new technologies later and their rate of use grew more slowly. The analysis found that differences in treatment rates were most pronounced when costly medical technologies were involved.
Conclusions
The authors—an international collaboration of investigators that is developing comparative evidence on trends in treatment, resource costs, and health outcomes for common health problems—conclude that differences in adoption and use of cardiac treatments "appear to be related to economic and regulatory incentives of the health care systems and may have important economic and health consequences."