The effects of reimbursement mechanisms on medical technology diffusion in the hospital sector in the Italian NHS

Objectives: The aim of this study was to investigate how the differences across the regionalreimbursement mechanisms and in particular the use of the DRGs impact on the level inthe high technology equipment diffusion.Methods: Based on hospital sector data at a regional level we build up indicators to measurethe regional diffusion of high technological medical equipment in the period 1997–2007.These indicators are regressed on regional healthcare characteristics to investigate the rela-tionship between the different reimbursement systems offered by Italian regions and thelevel of high technological medical equipment.Results: Our results suggest that the per-case payment system is generally associated witha lower level of regional technology endowment per million of inhabitants, especially forthe complex and expensive medical equipments.Conclusions: Our findings cast some doubts that an effective regulation of reimbursementmechanisms cannot limit the excessive diffusion of medical equipment that is a relevantdriver of the increase in expenditure.