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1 – 10 of over 50000Rajat Kumar Behera, Pradip Kumar Bala, Prabin Kumar Panigrahi and Shilpee A. Dasgupta
Despite technological advancements to enhance patient health, the risks of not discovering the correct interactions and trends in digital health are high. Hence, a careful policy…
Abstract
Purpose
Despite technological advancements to enhance patient health, the risks of not discovering the correct interactions and trends in digital health are high. Hence, a careful policy is required for health coverage tailored to needs and capacity. Therefore, this study aims to explore the adoption of a cognitive computing decision support system (CCDSS) in the assessment of health-care policymaking and validates it by extending the unified theory of acceptance and use of technology model.
Design/methodology/approach
A survey was conducted to collect data from different stakeholders, referred to as the 4Ps, namely, patients, providers, payors and policymakers. Structural equation modelling and one-way ANOVA were used to analyse the data.
Findings
The result reveals that the behavioural insight of policymakers towards the assessment of health-care policymaking is based on automatic and reflective systems. Investments in CCDSS for policymaking assessment have the potential to produce rational outcomes. CCDSS, built with quality procedures, can validate whether breastfeeding-supporting policies are mother-friendly.
Research limitations/implications
Health-care policies are used by lawmakers to safeguard and improve public health, but it has always been a challenge. With the adoption of CCDSS, the overall goal of health-care policymaking can achieve better quality standards and improve the design of policymaking.
Originality/value
This study drew attention to how CCDSS as a technology enabler can drive health-care policymaking assessment for each stage and how the technology enabler can help the 4Ps of health-care gain insight into the benefits and potential value of CCDSS by demonstrating the breastfeeding supporting policy.
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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 of…
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.
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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 has…
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.
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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 health…
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.
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 and under…
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.
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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 processes to…
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.
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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.
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.
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The broad perspective and synthetic approach of technologyassessment raises the question whether the technology assessment modelcan be utilised for practical decision support. The…
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.
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This survey explores the application of real options theory to the field of health economics. The integration of options theory offers a valuable framework to address these…
Abstract
Purpose
This survey explores the application of real options theory to the field of health economics. The integration of options theory offers a valuable framework to address these challenges, providing insights into healthcare investments, policy analysis and patient care pathways.
Design/methodology/approach
This research employs the real options theory, a financial concept, to delve into health economics challenges. Through a systematic approach, three distinct models rooted in this theory are crafted and analyzed. Firstly, the study examines the value of investing in emerging health technology, factoring in future advantages, associated costs and unpredictability. The second model is patient-centric, evaluating the choice between immediate treatment switch and waiting for more clarity, while also weighing the associated risks. Lastly, the research assesses pandemic-related government policies, emphasizing the importance of delaying decisions in the face of uncertainties, thereby promoting data-driven policymaking.
Findings
Three different real options models are presented in this study to illustrate their applicability and value in aiding decision-makers. (1) The first evaluates investments in new technology, analyzing future benefits, discount rates and benefit volatility to determine investment value. (2) In the second model, a patient has the option of switching treatments now or waiting for more information before optimally switching treatments. However, waiting has its risks, such as disease progression. By modeling the potential benefits and risks of both options, and factoring in the time value, this model aids doctors and patients in making informed decisions based on a quantified assessment of potential outcomes. (3) The third model concerns pandemic policy: governments can end or prolong lockdowns. While awaiting more data on the virus might lead to economic and societal strain, the model emphasizes the economic value of deferring decisions under uncertainty.
Practical implications
This research provides a quantified perspective on various decisions in healthcare, from investments in new technology to treatment choices for patients to government decisions regarding pandemics. By applying real options theory, stakeholders can make more evidence-driven decisions.
Social implications
Decisions about patient care pathways and pandemic policies have direct societal implications. For instance, choices regarding the prolongation or ending of lockdowns can lead to economic and societal strain.
Originality/value
The originality of this study lies in its application of real options theory, a concept from finance, to the realm of health economics, offering novel insights and analytical tools for decision-makers in the healthcare sector.
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Peivand Bastani, Ali Tahernezhad and Seyyed Mostafa Hakimzadeh
According to the importance of strategic purchasing as an effective tool for resource allocation and service procurement, this study examines national laws, regulations and other…
Abstract
Purpose
According to the importance of strategic purchasing as an effective tool for resource allocation and service procurement, this study examines national laws, regulations and other related documents related to the strategic purchasing of health services related to the advanced medical equipment in Iran.
Design/methodolgy/approach
It was a national qualitative document analysis conducted in 2019 applying content analysis approach. The four-step Scott method was used to include the documents in terms of authenticity, credibility, representation and meaningfulness. After retrieving the related documents, they were coded with the implicit and explicit approach. MAXQDA10 was used for content analysis.
Findings
The findings show that according to the framework of effective factors on the strategic purchasing of health services, seven main factors are determined as the main essential factors in purchasing advanced medical equipment. These factors consist of health care providers, health service buyers, purchaser and service provider contracts, payment mechanisms, organization and management evaluation of health technology including expensive medical equipment and technology-related.
Research limitation/implication
The study had some limitations as follows: the proposed method should be tested and its feasibility has to be investigated through appropriate tools for Iranian insurance companies and those with the similar settings.
Practical implication
The results of this study can shed more light for policy makers affiliated in Ministry of Health as the main service provider, Ministry of Welfare and the insurance agencies as the main purchasers of health services on paying attention to these seven main themes extracted from the upstream documents and laws and regulations of the Islamic Republic of Iran.
Social implication
The strategic purchasing of expensive high technology-based medical equipment is a necessity for Iranian public health insurance organizations that is emphasized in national documents in the way of implementing this necessity.
Originality/value
This study examines all the laws and regulations and all related documents in the strategic purchasing of health services related to advanced medical equipment, giving an analysis of the most important challenges and requirements of implementing strategic purchasing in the health services provision sector with expensive medical equipment.
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