Skip to main content

Advertisement

Log in

Innovation in hospitals: a survey of the literature

  • Original paper
  • Published:
The European Journal of Health Economics Aims and scope Submit manuscript

Abstract

The literature on innovation in hospitals is relatively extensive and varied. The purpose of this article is to conduct a critical survey, and in particular to highlight the functional and occupational bias that characterises it, whereby the sole object of innovation is medical care, and that innovation is essentially the work of doctors. In order to achieve this objective, four different (complementary or competing) concepts of the hospital are considered. In the first, the hospital is seen in terms of its production function, in the second, as a set of technical capacities, in the third, as an information system, and in the fourth, as a service provider and a hub in a wider system of healthcare. In the latter approach, hospitals are regarded as combinative providers of diverse and dynamic services, able to go beyond their own institutional boundaries by becoming part of larger networks of healthcare provision, which are themselves diverse and dynamic. This approach makes it possible to extend the model of hospital innovation to incorporate new forms of innovation and new actors in the innovation process, in accordance with the Schumpeterian tradition of openness.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

Notes

  1. The categories in question may overlap with each other. After all, the definitions adopted in the literature often vary depending on the studies and authors in question.

References

  1. Phelps, C.: Health Economics, p. 559. Harper-Collins, New York (1992)

    Google Scholar 

  2. Shephard, R.W.: Theory of Cost and Production Functions. Princeton University Press, Princeton (1970)

    Google Scholar 

  3. Newhouse, J.P.: Towards a theory of non profit institutions: an economic model of the hospital. Am. Econ. Rev. 60, 64–74 (1970)

    Google Scholar 

  4. Conrad, R.F., Strauss, R.P.: A multiple-output multiple input model of the hospital industry in North Carolina. Appl. Econ. 15, 341–352 (1983)

    Article  Google Scholar 

  5. Ahern, M.: The softness of medical production and implications for specifying hospital outputs. J. Econ. Behav. Organ. 20, 281–294 (1993)

    Article  Google Scholar 

  6. Béjean, S., Gadreau, M.: Quelles théories économiques pour l’hôpital? Cah. Lillois Econ. Sociol. 18, 26–40 (1991)

    Google Scholar 

  7. Piatecki, C., Ulmann, P.: La micro-économie de la santé: bilan et perspectives. Rev. Econ. Financière 34:47–69 (1995)

    Google Scholar 

  8. Schrayer, S.: Les technologies médicales: une industrie de la santé, p. 168. Editions Pradel, Paris (1995)

    Google Scholar 

  9. Thomas, L.: The Lives of a Cell, p. 180. Bantam Books, New York (1975)

    Google Scholar 

  10. Nystrom, P.C., Ramamurthy, K., Wilson, A.: Organizational context, climate and innovativeness: adoption of imaging technology. J. Eng. Technol. Manag. 19(3), 221–247 (2002)

    Article  Google Scholar 

  11. Jerome-D’Emilia, B., Begun, J.W.: Diffusion of breast conserving surgery in medical communities. Soc. Sci. Med. 60, 143–151 (2005)

    Article  Google Scholar 

  12. Hashimoto H, et al. (2006) The diffusion of medical technology, local conditions, and technology re-invention: a comparative study on coronary stenting. Health Policy 79:221–230

    Google Scholar 

  13. Majnoni D’Intignano, B., Ulmann, P.: Economie de la santé, p. 438. PUF, Paris (2001)

    Google Scholar 

  14. Paraponaris, A., Moatti, J.P., Mossé, P., Huard, P.: Economie de l’innovation médicale: bilan et perspectives. In: Sailly, J.-C., Lebrun, T. (eds.) Dix ans d’avancées en économie de la santé, pp. 225–233. Editions John Libbey Eurotext, Montrouge (1997)

    Google Scholar 

  15. Laroche, S., Allenet, B., Foroni, L., Calop, J.: Apport décisionnel de l’analyse médico-économique de l’innovation à l’hôpital: le cas de la fermeture des communications inter-auriculaires par voie percutanée. J. Econ. Med. 19(7–8), 491–501 (2001)

    Google Scholar 

  16. Evans, R.: Finding the levers, finding the courage: lessons from cost-containment in North America. J. Health Polit. Policy Law 11, 585–616 (1986)

    Google Scholar 

  17. Weisbrod, B.: The health care quadrilemna: an essay on technological change, insurance, quality of care, and cost containment. J. Econ. Lit. 29, 523–552 (1991)

    Google Scholar 

  18. Frija, G., Kalaï, A., Hernigou, A., Grataloup, C., Revel, M.P.: Imagerie non isotopique. In: Broun, G. (ed.) Le plateau technique médical à l’hôpital, pp. 225–263. Editions Eska, Paris (2002)

    Google Scholar 

  19. De Kervasdoué, J., Lacronique, J.-F.: L’état et la technique: l‘apparition du rationnement. In: De Kervasdoué, J., Kimberly, J., Rodwin, V. (eds.) La santé rationnée: la fin d’un mirage, pp. 89–116. Economica, Paris (1981)

    Google Scholar 

  20. Nègre, M., Cayrol, B., Sebah, H.: Substitution ou complémentarité des techniques médicales: la pratique endoscopique et radiologique des gastro-entérologues. J. Econ. Med. 7(6 bis), 19–30 (1989)

    Google Scholar 

  21. Beresniak, A., Duru, G.: Economie de la santé, p. 216. Masson, Paris (2001)

    Google Scholar 

  22. Eddy, D.: Screening for cervical cancer. Ann. Intern. Med. 113, 214–226 (1990)

    Google Scholar 

  23. Eisinger, F., Giordanella, J.P., Allemand, H., Benech, J.M.: Dépistage du cancer du sein. Le coût du temps et de l’espace. Rev. Med. de l’Assurance Mal. 2, 128–133 (1995)

    Google Scholar 

  24. Moatti, J.P.: Ethique médicale, économie de la santé: les choix implicites. Ann. Mines 22, 74–80 (1991)

    Google Scholar 

  25. Durieux, P., Blum, C., Jolly, D.: Evaluation des technologies médicales à l’hôpital. J. Econ. Med. 2:103–112 (1986)

    Google Scholar 

  26. Béjean, S., Gadreau, M.: Du calcul économique à l’évaluation organisationnelle des politiques de santé. Rev. Fr. Econ. XI(1), 21–47 (1996)

    Google Scholar 

  27. McGregor, M., Brophy, J.M.: End-user involvement in health technology assessment development: a way to increase impact. Int. J. Technol. Assess. Health Care 21(2), 263–267 (2005)

    Google Scholar 

  28. Altman, S.H., Blendon, R. (eds.): Medical Technology: The Culprit Behind Health Care Costs? Department of Headline, Education and Welfare, Washington (1977)

  29. Ginzberg, E.: High tech medicine and rising health care costs. JAMA 263(13), 1820–1822 (1990)

    Article  Google Scholar 

  30. Newhouse, J.P.: Medical care costs: how much welfare loss? J. Econ. Perspect. 6(3), 3–23 (1992)

    Google Scholar 

  31. Fuchs, V.: Economics, values and health care reform. Am. Econ. Rev. 86, 1–24 (1996)

    Google Scholar 

  32. Cutler, D.M., Huckman, R.S.: Technological development and medical productivity: the diffusion of angioplasty in New York State. J. Health Econ. 22(2), 187–217 (2003)

    Article  Google Scholar 

  33. L’horty, Y., Quinet, A., Rupprecht, F.: Expliquer la croissance des dépenses de santé: le rôle du niveau de vie et du progrès technique. Econ. Previs. 129–130(3–4), 257–268 (1997)

    Google Scholar 

  34. Cutler, D.: A guide to healthcare reform. J. Econ. Perspect. 8: 13–29 (1994)

    Google Scholar 

  35. Le Pen, C.: Théorie de l’utilité et mesure des états de santé: le débat QALYs-HYEs. Econ. Previs. 129–130(3–4), 37–54 (1997)

    Google Scholar 

  36. Weinstein, M., Stason, W.: Foundations of cost–effectiveness analysis for health and medical practices. N. Engl. J. Med. 296, 716–721 (1977)

    Article  Google Scholar 

  37. Williams, A.: Economics of coronary artery bypass grafting. BMJ 291, 326–329 (1985)

    Article  Google Scholar 

  38. Chandernagor, P., Claveranne, J.P., Krichen, M.: Le statut des équipements hospitaliers: stratégie(s) d’acteur(s) et ordre technicien. In: Contandriopoulos, A.P., Souteyrand, Y. (eds.) L’hôpital stratège, pp. 257–267. John Libbey Eurotext, Montrouge (1996)

    Google Scholar 

  39. Anatole-Touzet, V., Souffir, W.: Innovation technologique, organisation du travail et gestion des compétences. Gestions Hosp. 354, 222–225 (1996)

    Google Scholar 

  40. Gallouj, F.: Innovation in the service economy: the new wealth of nations, p. 226. Edwar Elgar Publishing, Cheltenham, Northampton (2002)

    Google Scholar 

  41. Acker, F.: L’informatisation des unités de soins et travail de formalisation de l’activité infirmière. Sci. Soc. Sante. 13(3), 69–91 (1995)

    Google Scholar 

  42. Hémidy, L.: L’informatisation des hôpitaux et ses enjeux. Rev. Fr. Gestion 109: 125–136 (1996)

    Google Scholar 

  43. England, I., Stewart, D., Walker, S.: Information technology adoption in health care: when organisations and technology collide. Aust. Health Rev. 23(3), 176–185 (2000)

    Article  Google Scholar 

  44. Burke, D.E., Menachemi, N.: Opening the black-box: measuring hospital information technology capability. Health Care Manag. Rev. 29(3), 210–217 (2004)

    Google Scholar 

  45. Stanback, T.: Computerization and the transformation of employment: government, hospitals and universities, p. 151. Westview, Boulder (1987)

    Google Scholar 

  46. Sachot, E.: La productique entre à l’hôpital. Polit. Ind. (winter), 135–141 (1989)

    Google Scholar 

  47. Berbain, X., Minvielle, E.: Informatique et gestion des unités de soins. Sci. Soc. Sante. 19(3), 77–106 (2001)

    Google Scholar 

  48. Child, J., Loveridge, R., Harvey, J., Spencer, A.: The quality of employment in services. In: Forester, T. (ed.) The information technology revolution, pp. 419–438. Basil Blackwell, Oxford (1985)

    Google Scholar 

  49. Blackburn, P., Coombs, R., Green, K.: Technology, economic growth and the labour process, p. 239. St Martin, New York (1985)

    Google Scholar 

  50. Djellal, F., Gallouj, F.: Innovation in care services for the elderly. Serv. Ind. J. 26(3), 303–327 (2006)

    Article  Google Scholar 

  51. David, A., Midy, F., Moisdon, J.C.: Les TIC restructurent-elles? péripéties de deux réseaux de télémédecine en périnatalité. Rev. Fr. Aff. Soc. 3, 69–94 (2003)

    Google Scholar 

  52. Kerlau, M., Pelletier-Fleury, N.: Restructuration du système de soin et diffusion de la télémédicine. La dynamique de l’innovation en santé, 2nd Conference of the Collège des économistes de la santé, February, CNAM (2001)

  53. Arras, J.D. (ed.): Bringing the hospital home, p. 259. John Hopkins University Press, Baltimore (1995)

  54. Mehlman, M.J., Youngner, S.J. (eds.): Delivering high technology home care, p. 214. Springer, Berlin Heidelberg New York (1991)

  55. Bentur, N.: Hospital at home: what is its place in the health system. Health Policy 55, 71–79 (2001)

    Article  Google Scholar 

  56. Le Goff Pronost, M., Lethiais, V.: Planification de l’offre de soins entre deux zones géographiques et télémédecine, Workshop TIC et réorganisation spatiale des activités économiques, ENST, Brest, 21–22 November 2002

  57. Silver, H.: Vers une gestion flexible des services professionnels? le cas des hôpitaux et des services juridiques aux Etats-Unis. In: Gadrey, J., Gadrey, N. (eds.) La gestion des ressources humaines dans les services et le commerce, pp. 165–180. L’Harmattan, Paris (1992)

    Google Scholar 

  58. Dent, M.: Professions, information technology and management in hospitals, p. 212. Avebury, London (1996)

    Google Scholar 

  59. Vendramin, P., Valenduc, G.: Technologies et flexibilité: les défis du travail à l’ère numérique, p. 180. Editions Liaisons, Paris (2002)

    Google Scholar 

  60. Carré, D., Lacroix, J.G.: Virage ambulatoire et autoroutes de l’information dans le secteur de la santé. Sci. Soc. 47, 23–40 (1999)

    Google Scholar 

  61. Schweyer, F.X.: Les directeurs d’hôpital peuvent-ils jouer un rôle dans l’organisation du travail de soins? In: Cresson, D., Schweyer, F.X. (eds.) Professions et institutions de santé face à l’organisation du travail, pp. 149–170. Editions ENSP, Paris (2000)

    Google Scholar 

  62. Fuchs, V.: The health sector’s share of the gross national product. Science 247, 534–538 (1990)

    Article  Google Scholar 

  63. De Kervasdoué, J.: La santé intouchable: enquête sur une crise et ses remèdes, p. 294. Editions Jean Claude Lattès, Paris (1996)

    Google Scholar 

  64. Gadrey, J.: Services: la productivité en question, p. 358. Desclée de Brouwer, Paris (1996)

    Google Scholar 

  65. Arbuz, G., Debrosse, D.: Réussir le changement de l’hôpital, p. 248. InterEditions, Paris (1996)

    Google Scholar 

  66. Bonafini, P.: Réseaux de soins: réforme ou révolution. Polit. Manag. Public 20(2), 1–22 (2002)

    Google Scholar 

  67. Lamarque, D.: L’innovation médicale et les dépenses de santé. Gestions Hosp. 240, 8–25 (1984)

    Google Scholar 

  68. McConnell, C.R.: Larger, smaller, and flatter: the evolution of the modern health care organization. Health Care Manag. 24(2), 177–188 (2005)

    Google Scholar 

  69. Bachimont, J.: Les soins hospitaliers à domicile: l’exemple de la mucovicidose in Substitutions et complémentarités thérapeutiques, migration des patients. Report for MIRE (no. 401/90), Inserm, Paris (1993)

  70. Bachimont, J.: Les soins hospitaliers à domicile entre démédicalisation hospitalière et médicalisation du domicile. In: Aïach, P., Delanoë, D. (eds.) L’ère de la médicalisation: Ecce homo sanitas, pp. 175–209. Anthropos, Paris (1998)

    Google Scholar 

  71. Alignon, A., Com-Ruelle, L., Renaud, T.: Evaluation du coût de la prise en charge globale en hospitalisation à domicile. Report CREDES no. 1484, June (2003)

  72. Busson, O., Doussin, A., Sourty Le Guellec, M.J.: Chirurgie ambulatoire: comparaison France et Etats-Unis, Conference “journées thématiques sur l’hospitalisation”, CNAMTS, Lille, 25–26 November 1999

  73. Lega, F., DePietro, C.: Converging patterns in hospital organization; beyond the professional bureaucracy. Health Policy 74(3), 261–281 (2005)

    Article  Google Scholar 

  74. Young, G., Charns, M.P., Shortell, S.M.: Top manager and network effects on the adoption of innovative management practices: a study of TQM in a public hospital system. Strateg. Manag. J. 22, 935–951 (2001)

    Article  Google Scholar 

  75. Dubois, C.A.: Renouveau managérial dans le contexte des réformes des services de santé: mirage ou réalité? Sci. Soc. Sante. XXI(4), 41–71 (2003)

    Google Scholar 

  76. Minvielle, E.: De l’usage de concepts gestionnaires dans le champ de la santé. Le cas de la qualité hospitalière. Rev. Fr. Gestion XXIX(146), 168–189 (2003)

    Google Scholar 

  77. Madorran Garcia, C., de Val Pardo, I.: Strategies and performance in hospitals. Health Policy 67(1), 1–13 (2004)

    Article  Google Scholar 

  78. Naiditch, M., de Pouvourville, G.: Le programme de médicalisation du système d’information (hospitalier): une expérimentation sociale limitée pour une innovation majeure du management hospitalier. Rev. Fr. Aff. Soc. 1, 59–95 (2000)

    Google Scholar 

  79. Midttun, L., Martinussen, P.E.: Hospital waiting time in Norway: what is the role of organizational change? Scand. J. Public Health 33(6), 439–446 (2005)

    Google Scholar 

  80. Sasaki, L.: Hospital offer unconventional services in hopes of attracting future patients. Hosp. Q. 6(3), 85–86 (2003)

    Google Scholar 

  81. Barreau, J.: Les services publics français et l’innovation sociale. In: Djellal, F., Gallouj, F. (eds.) Nouvelle économie des services et innovation, pp. 165–185. L’Harmattan, Paris (2002)

    Google Scholar 

  82. Bellemou, A., Fraigneau, A.: La communication comme outil de management à l’hôpital. Gestions Hosp. 261–262, 763–766 (1987)

  83. Benedicto, M.: Le temps choisi à l’hôpital de Béziers. Gestions Hosp. 261–262, 749–750 (1987)

  84. Minvielle, E.: Un changement sur ordonnance. Gérer et Comprendre 35, 43–54 (1994)

    Google Scholar 

  85. Cases, C., Beaubeau, D., Naiditch, M.: Evaluer la capacité d’adaptation aux changements. Solidarité-Santé 2, 67–69 (2001)

    Google Scholar 

  86. Djellal, F., Gallouj, F.: Mapping innovation dynamics in hospitals. Res. Policy 34, 817–835 (2005)

    Article  Google Scholar 

Download references

Acknowledgement

We gratefully acknowledge the comments and suggestions by the three anonymous referees appointed by the journal.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Faïz Gallouj.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Djellal, F., Gallouj, F. Innovation in hospitals: a survey of the literature. Eur J Health Econ 8, 181–193 (2007). https://doi.org/10.1007/s10198-006-0016-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10198-006-0016-3

Keywords

JEL Classification

Navigation