spatial patenting in the medical equipment industry. Four factors have been analyzed:
firm size, proximity to medical activities, agglomeration, and networking.
Firm size
The relationship between firm size and invention∕innovation has been a matter of long□
standing debate (Rothwell and Dodgson 1994; Dijk et al 1997). Some scholars argue
that large size favours invention because larger firms have a greater capacity to raise
capital, manage information, maintain large R&D facilities and attract the best technical
specialists. However, other scholars (i.e. Rothwell and Zegveld 1982) stress the
importance of smaller roles, especially of ‘hiDtech’ firms, in the process of
technological change due to their greater flexibility to adapt to changes in external
environments (Noteboom 1994; Rothwell 1991). Besides, small firms explore more
technological areas by innovation in less ‘crowded’ areas, and are tied into regional
knowledge networks to a greater extent than large firms (Almeida and Kogut 1997).
The development of medical equipments requires different technical capabilities. While
it is possible to develop and manufacture surgery instruments in a very small ‘hiDtech’
firm, other medical equipments such as a magnetic resonance equipment demands large
technical resources which they are only available at large firms. Nevertheless an
analysis of the Spanish foreign trade of medical equipments revealed that the deficit is
greater in the ‘hiDtech’ small instruments than in the larger and more traditional
equipments (Martinez and Urbina 1998). Therefore we would establish the following
hypothesis:
Hl D Patent intensity at regional level is positively correlated with average firm size in
the medical equipment industry.
Proximity to medical activities
The second determinant of regional patenting activities included in this analysis is the
local proximity to medical equipment users. The development of medical equipment
requires a close UserDmanufacturer interaction between scientists and engineers in the
medical equipment companies and physicians and nurses in the hospitals and clinics
(Mitchell 1991). For example, Lotz (1991) found that, in the Danish medical equipment