Managed care, technology adoption, and health care: the adoption of neonatal intensive care

Rand J Econ. Autumn 2002;33(3):524-48.


Managed care may influence technology diffusion in health care. This article empirically examines the relationship between HMO market share and the diffusion of neonatal intensive care units. Higher HMO market share is associated with slower adoption of mid-level units, but not with adoption of the most advanced high-level units. Opposite the common supposition that slowing technology growth will harm patients, results suggest that health outcomes for seriously ill newborns are better in higher-level units and that reduced availability of mid-level units may increase their chance of receiving care in a high-level center, so that slower mid-level growth could have benefitted patients.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • California / epidemiology
  • Diffusion of Innovation*
  • Forecasting
  • Health Care Sector
  • Humans
  • Infant Mortality*
  • Infant, Newborn
  • Infant, Very Low Birth Weight
  • Intensive Care Units, Neonatal / economics
  • Intensive Care Units, Neonatal / statistics & numerical data*
  • Intensive Care Units, Neonatal / trends
  • Managed Care Programs / economics*
  • Managed Care Programs / trends
  • Outcome Assessment, Health Care
  • Proportional Hazards Models
  • United States / epidemiology