Long abstract

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Ischaemic heart disease is the world's leading cause of mortality, causing an estimated 7.1 million deaths in 1999 (WHO 2000). Heart disease is also one of the greatest contributors to health expenditures, comprising about 10% of total health expenditures in OECD countries (Moore et al 1997; Hodgson and Cohen 1999; Mathers and Penm 1999). This makes it an ideal disease for studying health care systems. Ischaemic heart disease (IHD) is a complex condition. Several risk factors for IHD can be tackled using a population health approach, while drugs can be used in primary and secondary prevention of the disease. It is the nature of treatment for the acute phase of ischaemic heart disease (IHD), generally involving high-cost, high-technology procedures that makes it an ideal disease to observe patterns of technology diffusion, a major component of this study.