scholarly journals The Impact of Health Technology Assessment on Decision-Making Processes in Public Versus Not-for-Profit Private Hospitals

2011 ◽  
Vol 2 (2) ◽  
pp. 72-78 ◽  
Author(s):  
Frederick
Keyword(s):  
Decision Making ◽  
Health Technology Assessment ◽  
Technology Assessment ◽  
Health Technology ◽  
Private Hospitals ◽  
For Profit ◽  
Not For Profit ◽  
Decision Making Processes ◽  
The Impact

ASSESSING THE IMPACT OF HEALTH TECHNOLOGY ASSESSMENT ON THE AUSTRIAN HEALTHCARE SYSTEM

2012 ◽  
Vol 29 (1) ◽  
pp. 84-91 ◽  
Author(s):  
Ines Schumacher ◽  
Ingrid Zechmeister
Keyword(s):  
Decision Making ◽  
Health Technology Assessment ◽  
Healthcare System ◽  
Technology Assessment ◽  
Health Technology ◽  
Media Analysis ◽  
System Level ◽  
Target Groups ◽  
Decision Making Processes ◽  
The Impact

Objectives: In Austria, research in health technology assessment (HTA) has been conducted since the 1990s. The aim of this study is to analyze whether the HTA research program of the Institute of Technology Assessment (ITA) and the Ludwig Boltzmann Institute for HTA (LBI-HTA) have had an impact on the Austrian healthcare system.Methods: We applied qualitative and quantitative empirical research methods, such as interviewing, download analysis, questionnaire, retrospective routine data analysis, and media analysis. Data were analyzed according to a conceptual framework, considering seven impact categories (awareness, acceptance, process, decision, practice, final outcomes, enlightenment) and different target groups.Results: A rising number of downloads and single HTA reports with high media interest were identified. Interviews showed that HTA reports have increasingly been used for investment and reimbursement decisions, as well as for the preparation of negotiations. Economic impact was indicated by decreased expenditures due to HTA recommendations. Overall, knowledge about evidence-based medicine increased and, in places, an “HTA culture” can be recognized. Yet, several decision-making processes occur at all levels without the use of HTA.Conclusions: The analysis demonstrated an impact within all predefined categories; however, it depends on the system level and its target groups. HTA reports are primarily used by hospital management, (social) insurances, and the Austrian Ministry of Health. Nevertheless, there is still potential to increase the impact of HTA. Therefore, the inclusion of HTA in decision-making processes in Austria needs to move from a voluntary basis to a mandatory one.

IMPACT OF HEALTH TECHNOLOGY ASSESSMENT REPORTS ON HOSPITAL DECISION MAKERS – 10-YEAR INSIGHT FROM A HOSPITAL UNIT IN SHERBROOKE, CANADA: IMPACT OF HEALTH TECHNOLOGY ASSESSMENT ON HOSPITAL DECISIONS

2018 ◽  
Vol 34 (4) ◽  
pp. 393-399 ◽  
Author(s):  
Thomas G. Poder ◽  
Christian A. Bellemare ◽  
Suzanne K. Bédard ◽  
Jean-François Fisette ◽  
Pierre Dagenais
Keyword(s):  
Decision Making ◽  
Health Technology Assessment ◽  
Technology Assessment ◽  
Contextual Factors ◽  
Health Technology ◽  
Decision Makers ◽  
Hospital Unit ◽  
Decision Making Processes ◽  
Process Factors ◽  
The Impact

Objectives:The overarching goal of this research was to (i) evaluate the impact of reports with recommendations provided by a hospital-based health technology assessment (HB-HTA) unit on the local hospital decision-making processes and implementation activities and (ii) identify the underlying factors of the nonimplementation of recommendations.Methods:All reports produced by the HB-HTA unit between December 2003 and March 2013 were retrieved, and hospital decision makers who requested these reports were solicited for enrolment. Participants were interviewed using a mixed design survey.Results:Twenty reports, associated with fifteen decision makers, fulfilled the study criteria. Nine decision makers accepted to participate, corresponding to thirteen reports and twenty-three recommendations. Of the twenty-three recommendations issued, 65 percent were implemented, 9 percent were accepted for implementation but not implemented, and 26 percent were declined. In terms of the utility of each report to guide decision makers, 92 percent of the reports were considered in the decision-making process; 85 percent had one or more recommendations adopted; and 77 percent had recommendations implemented. The most frequently mentioned reasons for nonimplementation were related to contextual factors (64 percent), production/diffusion process factors (14 percent), content/format factors (14 percent), or other factors (9 percent). Among the contextual factors, the complexity of the changes (i.e., administrative reasons), budget and resources constraints, failure to identify administrative responsibility to carry out the recommendation, and nonpriority status of the HTA recommendation, were provided.Conclusions:This study highlights that although HB-HTA reports are useful to hospital managers in their decision-making processes, certain barriers such as contextual factors need to be better addressed to improve HB-HTA efficiency and usefulness.

scholarly journals Introducing health technology assessment in Tanzania

2019 ◽  
Vol 36 (2) ◽  
pp. 80-86 ◽  
Author(s):  
Gavin Surgey ◽  
Kalipso Chalkidou ◽  
William Reuben ◽  
Fatima Suleman ◽  
Jacqui Miot ◽  
...  
Keyword(s):  
Decision Making ◽  
Health Technology Assessment ◽  
Low Income ◽  
Priority Setting ◽  
Technology Assessment ◽  
Health Technology ◽  
Sub Saharan Africa ◽  
Essential Medicines ◽  
Revision Process ◽  
Decision Making Processes

AbstractObjectivesHealth technology assessment (HTA) is a cost-effective resource allocation tool in healthcare decision-making processes; however, its use is limited in low-income settings where countries fall short on both absorptive and technical capacity. This paper describes the journey of the introduction of HTA into decision-making processes through a case study revising the National Essential Medicines List (NEMLIT) in Tanzania. It draws lessons on establishing and strengthening transparent priority-setting processes, particularly in sub-Saharan Africa.MethodsThe concept of HTA was introduced in Tanzania through revision of the NEMLIT by identifying a process for using HTA criteria and evidence-informed decision making. Training was given on using economic evidence for decision making, which was then put into practice for medicine selection for the NEMLIT. During the revision process, capacity-building workshops were held with reinforcing messages on HTA.ResultsBetween the period 2014 and 2018, HTA was introduced in Tanzania with a formal HTA committee being established and inaugurated followed by the successful completion and adoption of HTA into the NEMLIT revision process by the end of 2017. Consequently, the country is in the process of institutionalizing HTA for decision making and priority setting.ConclusionWhile the introduction of HTA process is country-specific, key lessons emerge that can provide an example to stakeholders in other low- and middle-income countries (LMICs) wishing to introduce priority-setting processes into health decision making.

scholarly journals Resource allocation and health technology assessment in Australia: Views from the local level

2009 ◽  
Vol 25 (02) ◽  
pp. 134-140 ◽  
Author(s):  
Gisselle Gallego ◽  
Kees van Gool ◽  
Dianne Kelleher
Keyword(s):  
Decision Making ◽  
Health Service ◽  
Health Technology Assessment ◽  
Technology Assessment ◽  
Online Survey ◽  
Local Level ◽  
Healthcare Providers ◽  
Health Technology ◽  
Health Technologies ◽  
Decision Making Processes

Objectives:Several studies have shown that a key determinant of successful health technology assessment (HTA) uptake is a clear, fair, and consistent decision-making process for the approval and introduction of health technologies. The aim of this study was to gauge healthcare providers' and managers' perceptions of local level decision making and determine whether these processes offer a conducive environment for HTA. An Area Health Service (AHS) aimed to use the results of this study to help design a new process of technology assessment and decision making.Methods:An online survey was sent to all health service managers and healthcare providers working in one AHS in Sydney, Australia. Questions related to perceptions of current health technology decisions in participants' own institution/facility and opinions on key criteria for successful decision-making processes.Results:Less than a third of participants agreed with the statements that local decision-making processes were appropriate, easy to understand, evidence-based, fair, or consistently applied. Decisions were reportedly largely influenced by total cost considerations as well as by the central state health departments and the Area executive.Conclusions:Although there are renewed initiatives in HTA in Australia, there is a risk that such investments will not be productive unless policy makers also examine the decision-making contexts within which HTA can successfully be implemented. The results of this survey show that this is especially true at the local level and that any HTA initiative should be accompanied by efforts to improve decision-making processes.

scholarly journals From idealistic rookies to a regional leader: The history of health technology assessment in Poland

2009 ◽  
Vol 25 (S1) ◽  
pp. 156-162 ◽  
Author(s):  
Rafał Niżankowski ◽  
Norbert Wilk
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Decision Making ◽  
Health Technology Assessment ◽  
Technology Assessment ◽  
Health Technology ◽  
The Public ◽  
History Of ◽  
Decision Making Processes ◽  
Public Payer

In 1989, Poland started to slowly release itself not only from the burden of a half-century of communist indoctrination and soviet exploitation, but also from the consequences of the Semashko model of healthcare organization: low doctors' salaries, primary care based on multispecialty groups, overdeveloped hospital infrastructure, and limited access to sophisticated interventions overcome by patients' unofficial payments.A few years after the 1998 workshop on health technology assessment (HTA) in Budapest, the first HTA reports were elaborated in the National Center for Quality Assessment in Health Care, which could mark the beginning of HTA in Poland. Several individuals and organizations have been involved in developing HTA, both from noncommercial and commercial standpoints.A goal to establish a national HTA agency appeared among the priorities of the Polish Ministry of Health in 2004 and was realized a year later. The Agency for HTA in Poland published guidelines on HTA and established a sound and transparent two-step (assessment-appraisal) process for preparing recommendations on public financing of both drugs and nondrug technologies. The recommendations of the Agency's Consultative Council were warmly welcomed by the public payer. However, the recent major restructuring of the Agency and new drug reimbursement decisions aroused doubts as to keeping transparency of the decision-making processes.

OP13 2017 Health Technology Assessment International Asia Policy Forum: The Perspective Of Not-For-Profit Members

2018 ◽  
Vol 34 (S1) ◽  
pp. 6-6
Author(s):  
Raoh-Fang Pwu ◽  
Rebecca Trowman
Keyword(s):  
Health Technology Assessment ◽  
Technology Assessment ◽  
Real World ◽  
Health Technology ◽  
The Philippines ◽  
Real World Data ◽  
World Data ◽  
For Profit ◽  
Not For Profit ◽  
Policy Forum

Introduction:The fifth Health Technology Assessment International (HTAi) Asia Policy Forum (APF) was held in Beijing, November 2017. The topic of the meeting was ‘Universal Health Care in the Asia Region: Overcoming the Barriers using HTA and Real World Data’. This presentation will focus on the use of real world data (RWD) as a mechanism of informing HTA in the Asia region – from the perspective of the not-for-profit HTA agencies that were represented at the APF.Methods:The 2017 HTAi APF had senior representatives from government and HTA agencies from 11 countries in the Asia region. This included first-time attendees from Iran, Indonesia and the Philippines. A keynote presentation on the lessons learnt from Taiwan on the use of RWD was delivered, and there were guided breakout group discussions.Results:There are a number of registries and sources of RWD available to the HTA agencies across the Asia region. However it was noted that the databases are resource intensive to maintain, and there are noted time lags in the data collection and release. There are examples where the data from these sources have been used to evaluate local utilization of treatments and post-market surveillance, but it has not yet been used in pricing/reimbursement decisions.Conclusions:Although RWD could be a good tool for healthcare decision-making in the Asia region, it is still unclear how to do so properly. Infrastructure and human capacity, as well as law, are key factors to the successful use of RWD. Standardized methodologies, increased transparency, quality control and capacity building are essential elements to better implementing RWD in HTA.

OP318 Health Technology Assessment And Decision-Making Processes: The Purchase Of Magnetic Resonance Imaging Technology

2021 ◽  
Vol 37 (S1) ◽  
pp. 13-13
Author(s):  
Maria Maia
Keyword(s):  
Magnetic Resonance Imaging ◽  
Decision Making ◽  
Magnetic Resonance ◽  
Health Technology Assessment ◽  
Technology Assessment ◽  
Health Technology ◽  
Decision Makers ◽  
Decision Making Process ◽  
Resonance Imaging ◽  
Decision Making Processes

IntroductionMedical devices play an essential role in health care, but they are also a leading causes of increasing healthcare expenditures. The purchase of technologies and the determination of how and when they should be used are among the most important decisions made by decision-makers, at the institutional level.The present research focuses on the Portuguese health system and sheds light on the characterization of decision-making process by those involved in Magnetic Resonance Imaging (MRI) purchases.MethodsTo characterize the decision-making process, results from forty questionnaires and twenty-seven semi-structured interviews with key decision-makers were merged, using a mixed method approach. To assess competences for decision-making, a questionnaire was applied, and Exploratory and Confirmatory Factorial Analysis conducted.ResultsCost and suppliers’ characteristics are seen as the most important indicators to guide decisions. The decision is undertaken by a committee, in a bottom-up process, characterized by a bounded rationality, influenced by intuition and a consultant decision-maker. The reasoning and justification for selection of the committee members is unclear. The decision process is considered to be bureaucratic, time-consuming and long. Patients are negatively perceived as stakeholders in the process. Few studies were performed (mostly related to the workload of the Radiology Department) to support the decision and no national or international health technology assessment (HTA) study was used in the process, to guide decisions. Decision-makers have limited knowledge and training in areas of decision-making in the areas of health informatics, health economics and especially HTA. This may limit their ability to truly understand the future implications of their purchase decisions.ConclusionsTo foster HTA in decision-making processes, recommendations are made, in particular, to: (i) establish an HTA in-house unit, able to carry out studies considering the hospital context and aiming to inform managerial local decisions (ii) promote a team comprised of technology assessment multidisciplinary researchers but also professionals from the health institution able to carry out HTA studies (iii) foster common languages and values to increase uptake of HTA studies.

THE IMPACT OF HEALTH TECHNOLOGY ASSESSMENT REPORTS ON DECISION MAKING IN AUSTRIA

2012 ◽  
Vol 28 (1) ◽  
pp. 77-84 ◽  
Author(s):  
Ingrid Zechmeister ◽  
Ines Schumacher
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Health Technology Assessment ◽  
Technology Assessment ◽  
Health Care Expenditure ◽  
Health Technology ◽  
Decision Making Process ◽  
Inclusion Criteria ◽  
Distribution Of Resources ◽  
The Impact

Objectives: Health technology assessment (HTA) was established in Austria in the 1990s and, since then, it has gained considerable importance. In this study, we aim to analyze whether the HTA reports that have been produced at the Institute for Technology Assessment (ITA) and at the Ludwig Boltzmann Institute for HTA (LBI-HTA) have had an impact on decision making within the Austrian health care system.Methods: We selected all reports that were intended for supporting (i) reimbursement/investment or (ii) disinvestment decisions. Eleven full HTA reports and fifty-eight rapid assessments fulfilled the inclusion criteria. We used interview data and administrative data on volumes, tariffs and expenditure of products/services to analyze whether and how reports were in reality used in decision making and what the consequences for health care expenditure and resource distribution have been.Results: Five full HTA reports and fifty-six rapid technology assessments were used for reimbursement decisions. Four full HTA reports and two rapid assessments were used for disinvestment decisions and resulted in reduced volumes and expenditure. Two full HTA reports showed no impact on decision making. Impact was most evident for hospital technologies.Conclusions: HTA has played some role in reducing volumes of over-supplied hospital technologies, resulting in reduced expenditure for several hospital providers. Additionally, it has been increasingly included in prospective planning and reimbursement decisions of late, indicating re-distribution of resources toward evidence-based technologies. However, further factors may have influenced the decisions, and the impact could be considerably increased by systematically incorporating HTA into the decision-making process in Austria.

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