OBJECTIVES: to analyze the determining factors underlying the extent to which positron emission tomography (PET) is used in a selected medical services provider covered by private health insurance plans in Brazil. METHODS: a qualitative case study was undertaken with data collected by means of in-depth interviews (N=9) with representatives of four private health service providers and three health insurance plan operators. RESULTS: the decisions to acquire the technology under study are taken by managers of hospitals and clinics that adopt a strategy based on excellence in technology. The factors that influence the decision are: a history of being pioneers in the introduction of new technology; pressure from the institution's clinical staff; the prestige of the physician or the area covered by the unit; the financial resources available; ease of access to technology; competition among health service providers; scientific evidence; and the expected return on the investment. CONCLUSIONS: the policy instruments currently used to manage the use of medical technology in the Brazilian health system has little influence on the decisions made by large-scale private service providers, whose activities are not necessarily related to the health needs of the population or the priorities of public health policy.
Diffusion of innovation; Biomedical technology; Positron-emission tomography; Health sciences; technology and innovation management; Brazil
