2023-09-28 14:46:10 +00:00
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abstract: 'Background The development of products and services for health care
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systems is one of the most important phenomena to have occurred in the
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field of health care over the last 50 years. It generates significant
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commercial, medical and social results. Although much has been done to
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understand how health technologies are adopted and regulated in
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developed countries, little attention has been paid to the situation in
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low- and middle-income countries (LMICs). Here we examine the
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institutional environment in which decisions are made regarding the
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adoption of expensive medical devices into the Brazilian health care
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system.
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Methods We used a case study strategy to address our research question.
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The empirical work relied on in-depth interviews (N = 16) with
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representatives of a wide range of actors and stakeholders that
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participate in the process of diffusion of CT (computerized tomography)
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scanners in Brazil, including manufacturers, health care organizations,
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medical specialty societies, health insurance companies, regulatory
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agencies and the Ministry of Health.
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Results The adoption of CT scanners is not determined by health policy
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makers or third-party payers of public and private sectors. Instead,
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decisions are primarily made by administrators of individual hospitals
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and clinics, strongly influenced by both physicians and sales
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representatives of the medical industry who act as change agents.
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Because this process is not properly regulated by public authorities,
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health care organizations are free to decide whether, when and how they
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will adopt a particular technology.
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Conclusions Our study identifies problems in how health care systems in
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LMICs adopt new, expensive medical technologies, and suggests that a set
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of innovative approaches and policy instruments are needed in order to
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balance the institutional and professional desire to practise a modern
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and expensive medicine in a context of health inequalities and basic
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health needs.'
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affiliation: 'Silva, HP (Corresponding Author), Univ Sao Paulo, Fac Med, Dept Prevent
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Med, Sch Med, Av Dr Arnaldo 455, BR-01246903 Sao Paulo, Brazil.
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Silva, Hudson P.; Viana, Ana L. D., Univ Sao Paulo, Fac Med, Dept Prevent Med, Sch
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Med, BR-01246903 Sao Paulo, Brazil.'
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author: Silva, Hudson P. and Viana, Ana L. D.
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author-email: hudson@usp.br
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author_list:
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- family: Silva
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given: Hudson P.
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- family: Viana
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given: Ana L. D.
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da: '2023-09-28'
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doi: 10.1093/heapol/czq076
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eissn: 1460-2237
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files: []
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issn: 0268-1080
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journal: HEALTH POLICY AND PLANNING
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keywords: Health technology diffusion; CT scanners; Brazil
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keywords-plus: CARE
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language: English
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month: SEP
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number: '5'
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number-of-cited-references: '31'
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orcid-numbers: 'Silva, Hudson P/0000-0001-7507-0917
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'
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pages: 385-394
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papis_id: aef0b822bd7beb820b29f2edd939828f
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ref: Silva2011healthtechnology
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researcherid-numbers: 'Silva, Hudson/ISU-3802-2023
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Silva, Hudson P/C-3969-2012
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Viana, Ana LD/B-2617-2013'
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times-cited: '16'
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title: 'Health technology diffusion in developing countries: a case study of CT scanners
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in Brazil'
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2023-10-01 08:15:07 +00:00
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type: article
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2023-09-28 14:46:10 +00:00
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unique-id: WOS:000294072400004
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usage-count-last-180-days: '1'
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usage-count-since-2013: '18'
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volume: '26'
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web-of-science-categories: Health Care Sciences \& Services; Health Policy \& Services
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year: '2011'
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