Abstract
Introduction: The main challenge of modern hospitals is purchasing medical technologies. Hospital-based health technology assessments (HB-HTAs) are used in healthcare facilities around the world to support management boards in providing relevant technologies for patients. Aim: This study was undertaken to update the existing body of knowledge on the characteristics of HB-HTA systems/models in the selected European countries. Insights gained from this study were used to provide an optimal approach for implementing HB-HTA in Poland. Materials and methods: Firstly, we carried out a systematic review in PubMed and embase. Secondly, we searched for gray literature via the AdHopHTA online handbook and the design book of the AdHopHTA project, as well as literature describing healthcare systems provided by the WHO. Then, we conducted in-depth interviews with HB-HTA experts from four countries. Finally, we selected ten countries from Europe and prepared frameworks for data collection and analyses. Results: The selected countries (Switzerland, Spain, France, Italy, Denmark, Finland, Sweden, the Netherlands, and Austria) are examples of decentralized or deconcentrated healthcare systems. In terms of HB-HTA, differences in organisational models (independent group, stand-alone, integrated-essential, integrated-specialised), type of financing (internally vs. externally), collaboration with an HTA National Agency and other stakeholders (e.g., Patients’ Associations) were identified. HB-HTA engages multi-skilled staff with various academic backgrounds and operates mainly on a voluntary basis. Conclusion: Strengths and weaknesses associated with various organisational models must be carefully considered in the context of support for decentralized or centralized models of implementation while embarking on HTA activities in Polish hospitals.
Highlights
The main challenge of modern hospitals is purchasing medical technologies
Healthcare systems are significantly developed in all analyzed countries, they represent various approaches to Hospital-based health technology assessments (HB-Health Technology Assessment (HTA))
HB-HTA units are present in European healthcare systems, which differ in terms of centralization, decentralization, and deconcentration; the absence of such initiatives in the older types of centralized healthcare systems are more likely to embark on HB-HTA activity
Summary
The main challenge of modern hospitals is purchasing medical technologies. Hospital-based health technology assessments (HB-HTAs) are used in healthcare facilities around the world to support management boards in providing relevant technologies for patients. Health Technology Assessment (HTA) influences drug reimbursement decisions are made by respective bodies on the basis of reliable scientific research results from the perspective of a particular healthcare system (INAHTA, 2015). An EU health technology assessment organization network EUNetHTA explains that HTA is a “multidisciplinary process that summarizes information on medical, social, economic, and ethical issues related to the use of a given health technology in a systematic, transparent, impartial and robust manner. Its purpose is to provide the information needed to create safe and effective patient-centred health policies and a desire to achieve the best value” (EUnetHTA, 2015). The main purpose of these agencies is to support healthcare system stakeholders in making decisions on optimal resource allocation
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