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Article
Publication date: 8 October 2018

Mohammadkarim Bahadori, Ramin Ravangard, Mahya Tohidi Nezhad, Naeimeh Pourtaheri and Sayyed Morteza Hosseini-Shokouh

According to the great importance of community health as well as the ever-increasing development of health technologies, the importance of designing an interactive model…

Abstract

Purpose

According to the great importance of community health as well as the ever-increasing development of health technologies, the importance of designing an interactive model of factors affecting health technology assessment (HTA) can be highlighted. The purpose of designing and implementing the framework of health information system assessment is to ensure that the required accurate data which are necessary to measure the main health indicators are available. The purpose of this paper is to design an interactive model of factors affecting HTA.

Design/methodology/approach

This is a cross-sectional, descriptive-analytic study conducted in the Iran Ministry of Health and Medical Education in the second half of 2017. A sample of 60 experts and professionals working in the field of health technologies are selected using purposive and snowball sampling methods. Two researcher-made questionnaires are used to collect the required data. The collected data are analyzed using decision-making trial and evaluation laboratory (DEMATEL) and MATLAB R2013a.

Findings

The results showed that “Legal dimension,” “safety,” “Effectiveness” and “Social dimension” were the affecting factors and net causes, and “Current application,” “Knowledge of technology,” “Ethical dimension,” “Costs” and “Organizational dimension” were the affected factors and net effects in the interactive model. Furthermore, “Legal dimension” with the coordinates C: [1.88, 1.27] and “Ethical dimension” with the coordinates C: [1.75, −75] were known as the most affecting and most affected factors in the interactive model, respectively.

Originality/value

The DEMATEL model is an appropriate tool for managers and policy makers to structure and prioritize factors influencing the HTA. Policy makers and decision makers can use this model for identifying relationships among factors and prioritize them. Because health policy makers and managers have a major role in formulating the regulations and guidelines related to the HTA, they should pay more attention to the legal considerations in their decisions and use the management tools to move the available resources toward implementing and enforcing rules and guidelines related to the HTA.

Book part
Publication date: 12 August 2014

Giovanni Radaelli, Emanuele Lettieri, Abraham B. (Rami) Shani, Cristina Masella and Michele Tringali

Healthcare policy-makers are implementing practices based on the logic of cost-opportunity to rationalize investments and resource consumption. The successful…

Abstract

Purpose

Healthcare policy-makers are implementing practices based on the logic of cost-opportunity to rationalize investments and resource consumption. The successful implementation of these practices depends on policy-makers’ capacity to involve professionals dispersed in the ecosystem, and who are unaccustomed to cooperating. Our case study investigates the institutional work pursued by the Lombardy Region to stimulate a Health Technology Assessment (HTA) program.

Design/methodology/approach

This chapter is based on a longitudinal case study of institutional change linked with a HTA program in the Lombardy Region. The HTA program initiatives were implemented during the 2009–2012 period. The case study is based on triangulating data from archival data, contents of the assessment forms and interviews with regional staff and experts.

Findings

The Lombardy Region implemented two distinct strategies, with mixed results. A strategy that was based on the formalization of the HTA program in a legislative direct through educational efforts did not obtain the commitment of the key actors in the relevant ecosystem. Subsequently, the Region implemented an ‘institutional work’ design strategy that included a combination of political, cultural, technical and structural work. This strategy stimulated local HTA experiments that might be used in the future to legitimize the full diffusion of the new practice in the ecosystem.

Originality/value

This study highlights a viable strategy of change that policy-makers can use to manage processes of institutional change in a professional ecosystem. The ‘institutional work’ strategy can support the establishment of new practices that incorporate the logic of cost-opportunity, which might rationalize the use of resources and improve investment decisions.

Article
Publication date: 1 March 2004

Arminée Kazanjian and Carolyn J. Green

Health technology assessment (HTA) has been identified as a national priority by a wide range of decision‐makers at the same time that a provincial cost constraint process…

759

Abstract

Health technology assessment (HTA) has been identified as a national priority by a wide range of decision‐makers at the same time that a provincial cost constraint process has decreased available funding. The contribution of the British Columbia Office of Health Technology Assessment is outlined in this paper along with consideration of ways in which both funding and the inclusion of HTA into health policy decision making can become more stable. An expanded HTA assessment framework to dovetail with increasing interest in equity issues is discussed.

Details

Clinical Governance: An International Journal, vol. 9 no. 1
Type: Research Article
ISSN: 1477-7274

Keywords

Book part
Publication date: 25 June 2012

Chunhuei Chi, Jwo-Leun Lee and Rebecca Schoon

Purpose – The purpose of this article is to investigate one core research question: How can health information technology (HIT) be assessed in a national health care…

Abstract

Purpose – The purpose of this article is to investigate one core research question: How can health information technology (HIT) be assessed in a national health care system context?

Design/methodology – We examine this question by taking a systematic approach within a national care system, in which the purpose of HIT is to contribute to a common national health care system's goal: to promote population health in an efficient way. Based on this approach we first develop a framework and our criteria of assessment, and then using Taiwan as a case study, demonstrate how one can apply this framework to assess a national system's HIT. The five criteria we developed are how well does the HIT (1) provide accessible and accurate public health and health care information to the population; (2) collect and provide population health and health care data for government and researchers to analyze population health and processes and outcomes of health care services; (3) provide accessible and timely information that helps to improve provision of cost-effective health care at an institutional level and promotes system-wide efficiency; (4) minimize transaction and administrative costs of the health care system; and (5) establish channels for population participation in governance while also protecting individual privacy.

Findings – The results indicate that Taiwan has high levels of achievement in two criteria while falling short in the other three. Major lessons we learned from this study are that HIT exists to serve a health care system, and the national health care system context dictates how one assesses its HIT.

Originality/value – There is a large body of literature published on the implementation of HIT and its impact on the quality and cost of health care delivery. The vast majority of the literature, however, is focused on a micro institutional level such as a hospital or a bit higher up, on an HMO or health insurance firm. Few have gone further to evaluate the implementation of HIT and its impact on a national health care system. The lack of such research motivated this study. The major contributions of this study are (i) to develop a framework that follows systems thinking principles and (ii) propose a process through which a nation can identify its objectives for HIT and systematically assess its national HIT system. Using Taiwan's national health care system as a case study, this paper demonstrated how it can be done.

Article
Publication date: 26 April 2022

Cristián Mansilla, Lucy Kuhn-Barrientos, Natalia Celedón, Rafael de Feria and Julia Abelson

Health systems are progressively stressed by health spending, which is partially explained by the increase in the cost of health technologies. Countries have defined…

Abstract

Purpose

Health systems are progressively stressed by health spending, which is partially explained by the increase in the cost of health technologies. Countries have defined processes to prioritize interventions to be covered. This study aims to compare for the first time health technology assessment (HTA) processes in Canada and Chile, to explain the factors driving these decisions.

Design/methodology/approach

This is a health policy analysis comparing HTA processes in Canada and Chile. An analysis of publicly available documents in Canada (for CADTH) and Chile (for the Ministry of Health (MoH)) was carried out. A recognized political science framework (the 3-I framework) was used to explain the similarities and differences in both countries. The comparison of processes was disaggregated into eligibility and evaluation processes.

Findings

CADTH has different programmes for different types of drugs (with two separate expert committees), whereas the MoH has a unified process. Although CADTH’s recommendations have a federal scope, the final coverage is a provincial decision. In Chile, the recommendation has a national scope. In both cases, past recommendations influence the scope of the evaluation. Pharmaceutical companies and patient associations are important interest groups in both countries. Whereas manufacturers and tumour groups are able to submit applications to CADTH, the Chilean MoH prioritizes applications submitted by patient associations.

Originality/value

Institutions, interests and ideas play important roles in driving HTA decisions in Canada and Chile, which is demonstrated in this novel analysis. This paper provides a unique comparison to highly relevant policy processes in HTA, which is often a research area dominated by effectiveness and cost-effectiveness studies.

Details

International Journal of Health Governance, vol. 27 no. 3
Type: Research Article
ISSN: 2059-4631

Keywords

Article
Publication date: 1 February 1997

Lesley Best, Andrew Stevens and Duncan Colin‐Jones

The Development and Evaluation Committee (DEC) provides local guidance on the value of new and existing health care technologies, including drugs, devices, procedures and…

Abstract

The Development and Evaluation Committee (DEC) provides local guidance on the value of new and existing health care technologies, including drugs, devices, procedures and health care settings. The system is made up of two components: i) literature review and cost‐effectiveness estimation of the proposed and current technologies, and ii) consideration by the Development and Evaluation Committee which arbitrates, makes recommendations and disseminates results across the South and West region. Sixty‐three reviews have been undertaken to date, including, for example, beta interferon for multiple sclerosis, pulsed dye laser in the treatment of port‐wine stains, and paclitaxel in ovarian cancer. The outcomes of this service are guides to purchasing which are both carefully researched and scrutinized.

Details

Journal of Clinical Effectiveness, vol. 2 no. 2
Type: Research Article
ISSN: 1361-5874

Article
Publication date: 17 May 2013

Paule Poulin, Lea Austen, Catherine M. Scott, Cameron D. Waddell, Elijah Dixon, Michelle Poulin and René Lafrenière

When introducing new health technologies, decision makers must integrate research evidence with local operational management information to guide decisions about whether…

Abstract

Purpose

When introducing new health technologies, decision makers must integrate research evidence with local operational management information to guide decisions about whether and under what conditions the technology will be used. Multi‐criteria decision analysis can support the adoption or prioritization of health interventions by using criteria to explicitly articulate the health organization's needs, limitations, and values in addition to evaluating evidence for safety and effectiveness. This paper seeks to describe the development of a framework to create agreed‐upon criteria and decision tools to enhance a pre‐existing local health technology assessment (HTA) decision support program.

Design/methodology/approach

The authors compiled a list of published criteria from the literature, consulted with experts to refine the criteria list, and used a modified Delphi process with a group of key stakeholders to review, modify, and validate each criterion. In a workshop setting, the criteria were used to create decision tools.

Findings

A set of user‐validated criteria for new health technology evaluation and adoption was developed and integrated into the local HTA decision support program. Technology evaluation and decision guideline tools were created using these criteria to ensure that the decision process is systematic, consistent, and transparent.

Practical implications

This framework can be used by others to develop decision‐making criteria and tools to enhance similar technology adoption programs.

Originality/value

The development of clear, user‐validated criteria for evaluating new technologies adds a critical element to improve decision‐making on technology adoption, and the decision tools ensure consistency, transparency, and real‐world relevance.

Details

Journal of Health Organization and Management, vol. 27 no. 2
Type: Research Article
ISSN: 1477-7266

Keywords

Article
Publication date: 15 June 2012

Sripen Tantivess, Román Pérez Velasco, Jomkwan Yothasamut, Adun Mohara, Hatai Limprayoonyong and Yot Teerawattananon

The purpose of this paper is to analyse the roles of social values in the reform of coverage decisions for Thailand's Universal Health Coverage (UC) plan in 2009 and 2010.

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Abstract

Purpose

The purpose of this paper is to analyse the roles of social values in the reform of coverage decisions for Thailand's Universal Health Coverage (UC) plan in 2009 and 2010.

Design/methodology/approach

Qualitative techniques, including document review and personal communication, were employed for data collection and triangulation. All relevant data and information regarding the reform and three case study interventions were interpreted and analysed according to the thematic elements in the conceptual framework.

Findings

Social values determined changes in the UC plan in two steps: the development of coverage decision guidelines and the introduction of such guidelines in benefit package formulation. The former was guided by process values, while the latter was shaped by different content ideals of stakeholders and policymakers. Analysis of the three interventions suggests that in allocating its resources to subsidise particular services, the UC authority took into account not only cost‐effectiveness, but also budget impacts, equity and solidarity. These social values competed with each other and, in many instances, the prioritisation of benefit candidates was not led solely by evidence, but also by value judgments, even though transparency was recognised as an ultimate goal of reform.

Research limitations/implications

The study findings indicate room for improvement and for future research – the current conceptual framework is inadequate to capture all the crucial elements which influence health prioritisation, as well as their interactions with social values.

Originality/value

The paper fills a gap in literature as it enhances understanding of the effects of social value judgments in real‐life health prioritisation.

Details

Journal of Health Organization and Management, vol. 26 no. 3
Type: Research Article
ISSN: 1477-7266

Keywords

Article
Publication date: 1 February 1991

M. Brommels

The broad perspective and synthetic approach of technologyassessment raises the question whether the technology assessment modelcan be utilised for practical decision…

Abstract

The broad perspective and synthetic approach of technology assessment raises the question whether the technology assessment model can be utilised for practical decision support. The idea is tested in the environment of local care decision making. Technology assessment‐like management instruments for assisting goal formulation, enhancement of organisational efficiency and quality assurance are presented.

Details

Journal of Management in Medicine, vol. 5 no. 2
Type: Research Article
ISSN: 0268-9235

Keywords

Book part
Publication date: 25 March 2010

John F.P. Bridges, Joshua P. Cohen, Peter G. Grist and Axel C. Mühlbacher

Purpose – Although the US has lagged behind international developments in health technology assessment (HTA), renewed interest in HTA in the US has been fueled by the…

Abstract

Purpose – Although the US has lagged behind international developments in health technology assessment (HTA), renewed interest in HTA in the US has been fueled by the appropriation of $1.1 billion comparative effectiveness research (CER) in 2009 and the debate over health care reform.

Approach – To inform CER practices in the US, we present case studies of HTA from England/Wales and Germany: contrasting methods; relevance to the US; and impact on innovation.

Findings – The National Institute of Health and Clinical Excellence (NICE) was established in 1999 to inform trusts within the National Health Service of England and Wales. It uses cost-effectiveness analysis to guide the allocation resource across preventative and curative interventions. In Germany, the Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen (IQWiG) was established in 2004 to inform reimbursement and pricing policies for the statutory sickness funds set by the Gemeinsamer Bundesausschuss (G-BA). IQWiG evaluates competing technologies within specific therapeutic areas, placing more weight on clinical evidence and the relative efficiency of competing therapies.

Practical implications – Although having deep political and cultural antecedents, differences between NICE and IQWiG can be explained by perspective: the former guiding resource allocation across an entire system (macro-evaluation), the latter focusing on efficiency within the bounds of a particular therapeutic area (micro-evaluation). Given the decentralized nature of the US health care system, and the relative powers of different medical specialties, the IQWiG model presents a more suitable case study to guided CER efforts in the US.

Details

Pharmaceutical Markets and Insurance Worldwide
Type: Book
ISBN: 978-1-84950-716-5

1 – 10 of over 53000