Health technology assessment: features of national / regional and hospital-based medical technology assessment

Abstract

The State Budget of Ukraine in 2021 is 159,2 billion UAH. It is 36.8 % more than in 2020, but this amount is still insufficient to cover all the healthcare needs in Ukraine. Economic hardships, the lack of funds in the healthcare system of Ukraine, as well as COVID-19 pandemic have increased the importance of Health Technology Assessment (HTA) as a tool of cost optimization. The introduction of hospital-based HTA along with national / regional HTA allows providing the use of effective, safe and economically justified health technologies that will give our citizens the access to treatment and the rational use of funds, in particular the budget ones. Aim. To analyze the world experience of using hospital-based HTA and its main differences from national / regional HTA. Materials and methods. The scientific information of international and domestic literary sources was analyzed. The methods of content analysis, historical, system-analytical and generalization were used during the research.Results. The authors reviewed the literature in Pubmed and Google Scholar databases devoted to the international experience of hospital-based HTA and its main differences from national / regional HTA. It has been determined that the transfer of the national / regional HTA results to the hospital level is hindered by a number of differences between the country as a whole and hospitals in particular. These include, first of all, features related to demographic indicators, epidemiology of diseases, the level of resistance, local approaches to treatment, various types of equipment used in hospitals, and others. In order to have practical benefits, HTA must be built taking into account the peculiarities of a medical institution where the health technologies studied will be used in the future.Conclusions. The need of effective management of hospital resources when a number of health technologies is increasing, the desire to improve clinical outcomes, improve the quality of life and its expectancy using health technologies with the proven effectiveness and safety, the need to evaluate medical equipment and consider organizational aspects related to introduction of a health technology, as well as assess the current equipment and treatment methods require to develop the scientific and practical approaches to hospital-based HTA and recommendations on collaboration between national / regional and hospitalbased HTA in Ukraine.