A comparison of the investment in hospital-based obstetrical ultrasound in Wales and Washington state

• Published in: International journal of technology assessment in health care Vol. 11; no. 3; p. 571
• Main Authors: Rosenblatt, R A, Dawson, A J, Larson, E H, Tressler, C J, Jones, A, Hart, L G, Nesbitt, T S
• Format: Journal Article
• Language: English
• Published: England 1995
• Subjects: Birth Rate; Capital Expenditures - statistics & numerical data; Cost Control; Diffusion of Innovation; Female; Health Facility Size; Hospital Costs; Humans; Investments - statistics & numerical data; Obstetrics and Gynecology Department, Hospital - economics; Pregnancy; Quality of Health Care; Ultrasonography, Prenatal - economics; Ultrasonography, Prenatal - instrumentation; Wales; Washington; Washington; Wales
• ISSN: 0266-4623
• DOI: 10.1017/S0266462300008734

The purpose of this study was to examine differences in the way Britain and the United States invest in and deploy a new medical technology. We used structured interviews to obtain information on the technical sophistication and approximate replacement value of all hospital-based obstetrical ultrasound machines in every maternity hospital in Washington state and Wales. The supply of hospital-based ultrasound machines--approximately two machines per 1,000 births--was similar in both countries. Wales had fewer advanced ultrasound machines than Washington state, and they were based exclusively in high-volume district general hospitals; there were no obstetric ultrasound machines in the private sector. In Washington state, the majority of advanced machines were in small and medium-sized hospitals, and many private offices had ultrasound machines. The approximate replacement value of hospital-based machines was three times as high per birth in Washington state as in Wales. In the case of obstetrical ultrasound, centralization of facilities, a relatively small private sector, and global budgeting lead to lower expenditures per patient within the National Health Service without compromising access to care.