Look to Norway! (But not uncritically)

The distribution of "big ticket" medical technologies in OECD countries. Organization for Economic Cooperation and Development

Five "big ticket" medical technologies (BTTs) in 1990 were compared in the 24 OECD countries in relation to population, the number of physicians, gross domestic product (GDP), and health care expenditures (HCE). Wide variations were observed between and within countries for all measures. Regression analysis revealed that HCE explains part of the variation in the distribution of computed tomography scanners (excluding Japan), magnetic resonance imaging units, and radiation therapy units (R2 between 0.40 and 0.69), but not extracorporeal shock wave lithotripters. To a lesser extent, GDP was also found to correlate with the distribution of these technologies, but no correlation was found with number of physicians. Other factors affecting the diffusion of these technologies are proposed for study.

Evaluation of medical equipment on the basis of users' experiences and hazard registration

Assessment of medical technologies is an important topic in health services research. The article describes a special aspect of user-related evaluation of devices in Norway. The Norwegian hospitals have high technical capacity and standards but the equipment is not assessed before being purchased by the hospitals. The idealistic rules for technology assessment are of no use in practical situations. The health authorities in Norway have established a national database for users' experiences and hazard registration. When assessing equipment, it is necessary to take into consideration the situation and the people handling the devices. A system-analytic perspective is proposed for better understanding. The database for experiences with devices stores information concerning maintenance, repair and service, i.e. the whole life history of the medical technology. All this information will be accessible for the hospitals through electronic mail or electronic meetings.