Setting Data extracted from HCUP-2 database assembled by the division of provider studies of agency for health care policy and research. 30 million discharge abstracts from 500 participating hospitals during period 1980 -1987. An average of 200,000 discharged patients per year were chosen. The total number of patients was not identified. Type of insurance did not play a role in abandonment.
New information appears to weakly promote reduction in use rather than complete abandonment.
Variables that presumably measures the clinical sophistication of the hospital, teaching status, board certification, were successful in explaining the rate of decline but not abandonment. The two primary mechanisms of affecting change in medical practice, the academic medical literature and reimbursement polices of third party payers work slowly and incompletely. Critique Presumably, medical technologies are introduced and abandoned based on scientific evidence. The continued use of IPPB raises questions about the forces that drive change in adopting medical technologies, and especially decisions to abandon clinically inappropriate procedures. This study addresses such questions by analyzing the decline in the rate of IPPB use in treating COPD patients between 1980-1987.