Ra. Rosenblatt et al., A COMPARISON OF THE INVESTMENT IN HOSPITAL-BASED OBSTETRICAL ULTRASOUND IN WALES AND WASHINGTON-STATE, International journal of technology assessment in health care, 11(3), 1995, pp. 571-584
The purpose of this study was to examine differences in the way Britai
n 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 Washin
gton state and Wales. The supply of hospital-based ultrasound machines
-approximately two machines per 1,000 births-was similar in both count
ries. Wales had fewer advanced ultrasound machines than Washington sta
te, and they were based exclusively in high-volume district general ho
spitals; there were no obstetric ultrasound machines in the private se
ctor. In Washington state, the majority of advanced machines were in s
mall and medium-sized hospitals, and many private offices had ultrasou
nd machines. The approximate replacement value of hospital-based machi
nes 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 co
mpromising access to care.