David Malenka

Dartmouth-Hitchcock Medical Center
One Medical Center Dr.

E-Mail: EmailAddress: hidden: you can email any NBER-related person as first underscore last at nber dot org
Institutional Affiliation: Dartmouth College

NBER Working Papers and Publications

June 2014The Diffusion of New Medical Technology: The Case of Drug-Eluting Stents
with Amitabh Chandra, Jonathan Skinner
in Discoveries in the Economics of Aging, David A. Wise, editor
There is considerable variation across hospitals and regions in the diffusion of new medical technologies. Before 2003, bare-metal stents were used by cardiologists seeking to perform revascularization for blockages in the heart. In April of 2003, the FDA approved the use of coated anti-proliferative but more expensive drug-eluting stents, designed to reduce re-narrowing of the artery at the location of the original stent. Adoption was rapid but uneven; in the year following their introduction, drug-eluting stents comprised 83% of total stents among Medicare enrollees in the top quintile of hospitals, but just 33% in the low quintile hospitals. We used the Medicare claims data to test several models of diffusion, and found empirical support for models of expertise (better quality hospitals...

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