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Technology assessment, priority setting, and appropriate care in Dutch health care

Published online by Cambridge University Press:  23 April 2004

Marc Berg ,
Tom van der Grinten  and
Niek Klazinga
Marc Berg
Affiliation:
Erasmus University, Rotterdam
Tom van der Grinten
Affiliation:
Erasmus University, Rotterdam
Niek Klazinga
Affiliation:
University of Amsterdam
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Abstract

This article provides a critical analysis of the impact of health technology assessment (HTA) on priority setting in The Netherlands. It describes the limited steering powers of the Dutch government; its complex interactions with insurers, health-care providers, and patients; and the role of HTA in this context as an attempt to rationalize the debate about cost-effectiveness issues. HTA has been drawn upon for decision making on the health insurance package. Also, HTA findings have been linked to the national guideline development programs of the medical community. However, these impacts by no means have been straightforward. We argue that the political nature of the priority-setting debate asks for a broader approach to what constitutes HTA, and how it should be drawn upon in priority setting. Suggestions are made on how to do justice to the social dynamics of decision making and the behavior of stakeholders in health-care systems.

Keywords

Health technology assessmentThe Netherlands
Type
Research Article
Information
International Journal of Technology Assessment in Health Care , Volume 20 , Issue 1 , January 2004 , pp. 35 - 43
Copyright
© 2004 Cambridge University Press

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