wow-inequalities/02-data/intermediate/wos_sample/9695518d9a5c2f0b68f90abee7f4ab6f-silva-hudson-p.-and/info.yaml

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abstract: 'Background The development of products and services for health care
systems is one of the most important phenomena to have occurred in the
field of health care over the last 50 years. It generates significant
commercial, medical and social results. Although much has been done to
understand how health technologies are adopted and regulated in
developed countries, little attention has been paid to the situation in
low- and middle-income countries (LMICs). Here we examine the
institutional environment in which decisions are made regarding the
adoption of expensive medical devices into the Brazilian health care
system.
Methods We used a case study strategy to address our research question.
The empirical work relied on in-depth interviews (N = 16) with
representatives of a wide range of actors and stakeholders that
participate in the process of diffusion of CT (computerized tomography)
scanners in Brazil, including manufacturers, health care organizations,
medical specialty societies, health insurance companies, regulatory
agencies and the Ministry of Health.
Results The adoption of CT scanners is not determined by health policy
makers or third-party payers of public and private sectors. Instead,
decisions are primarily made by administrators of individual hospitals
and clinics, strongly influenced by both physicians and sales
representatives of the medical industry who act as change agents.
Because this process is not properly regulated by public authorities,
health care organizations are free to decide whether, when and how they
will adopt a particular technology.
Conclusions Our study identifies problems in how health care systems in
LMICs adopt new, expensive medical technologies, and suggests that a set
of innovative approaches and policy instruments are needed in order to
balance the institutional and professional desire to practise a modern
and expensive medicine in a context of health inequalities and basic
health needs.'
affiliation: 'Silva, HP (Corresponding Author), Univ Sao Paulo, Fac Med, Dept Prevent
Med, Sch Med, Av Dr Arnaldo 455, BR-01246903 Sao Paulo, Brazil.
Silva, Hudson P.; Viana, Ana L. D., Univ Sao Paulo, Fac Med, Dept Prevent Med, Sch
Med, BR-01246903 Sao Paulo, Brazil.'
author: Silva, Hudson P. and Viana, Ana L. D.
author-email: hudson@usp.br
author_list:
- family: Silva
given: Hudson P.
- family: Viana
given: Ana L. D.
da: '2023-09-28'
doi: 10.1093/heapol/czq076
eissn: 1460-2237
files: []
issn: 0268-1080
journal: HEALTH POLICY AND PLANNING
keywords: Health technology diffusion; CT scanners; Brazil
keywords-plus: CARE
language: English
month: SEP
number: '5'
number-of-cited-references: '31'
orcid-numbers: 'Silva, Hudson P/0000-0001-7507-0917
'
pages: 385-394
papis_id: aef0b822bd7beb820b29f2edd939828f
ref: Silva2011healthtechnology
researcherid-numbers: 'Silva, Hudson/ISU-3802-2023
Silva, Hudson P/C-3969-2012
Viana, Ana LD/B-2617-2013'
times-cited: '16'
title: 'Health technology diffusion in developing countries: a case study of CT scanners
in Brazil'
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type: article
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unique-id: WOS:000294072400004
usage-count-last-180-days: '1'
usage-count-since-2013: '18'
volume: '26'
web-of-science-categories: Health Care Sciences \& Services; Health Policy \& Services
year: '2011'