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TOWARD A CONTINGENCY MODEL FOR HOSPITAL-BASED HEALTH TECHNOLOGY ASSESSMENT: EVIDENCE FROM ADHOPHTA PROJECT

Published online by Cambridge University Press:  16 April 2018

Americo Cicchetti ,
Valentina Iacopino ,
Silvia Coretti ,
Alessandra Fiore ,
Marco Marchetti ,
Laura Sampietro-Colom ,
Kristian Kidholm ,
Jean-Blaise Wasserfallen Open the ORCID record for Jean-Blaise Wasserfallen [Opens in a new window] ,
Rabia Kahveci  and
Esa Halmesmäki
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Americo Cicchetti
Affiliation:
Università Cattolica del Sacro Cuore, Faculty of Economics and Graduate School of Health Economics and Management
Valentina Iacopino
Affiliation:
Università Cattolica del Sacro Cuore, Faculty of Economics and Graduate School of Health Economics and [email protected]
Silvia Coretti
Affiliation:
Università Cattolica del Sacro Cuore, Faculty of Economics and Graduate School of Health Economics and Management
Alessandra Fiore
Affiliation:
Graduate School of Health Economics and Management, Università Cattolica del Sacro Cuore
Marco Marchetti
Affiliation:
National Center for Health Technology Assessment, National Institute of Health
Laura Sampietro-Colom
Affiliation:
Hospital-Based HTA Unit, Innovation and Research Directorate, Hospital Clinic Barcelona
Kristian Kidholm
Affiliation:
Department of Quality and Research/HTA, Odense University Hospital
Jean-Blaise Wasserfallen
Affiliation:
Lausanne University Hospital
Rabia Kahveci
Affiliation:
Ankara Numune Training and Research Hospital
Esa Halmesmäki
Affiliation:
Hospital District of Helsinki and Uusima
Magdalene Rosenmöller
Affiliation:
IESE Business School
Claudia Wild
Affiliation:
Ludwig-Boltzman Institute for HTA
Raul-Allan Kivet
Affiliation:
Tartu University Clinics
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Abstract

Objectives: Hospital-based health technology assessment (HB-HTA) is becoming increasingly relevant because of its role in managing the introduction and withdrawal of health technologies. The organizational arrangement in which HB-HTA activities are conducted depends on several contextual factors, although the dominant models have several similarities. The aims of this study were to explore, describe, interpret, and explain seven cases of the application of HB-HTA logic and to propose a classification for HB-HTA organizational models which may be beneficial for policy makers and HTA professionals.

Methods: The study was part of the AdHopHTA Project, granted under the European 7th Framework Research Programme. A case study methodology was applied to analyze seven HB-HTA initiatives in seven countries, with collection of qualitative and quantitative data. Cross-case analysis was performed within the framework of contingent organizational theory.

Results: Evidence showed that some organizational or “structural” variables, namely the level of procedure formalization/structuration and the level of integration with other HTA bodies at the national, regional, and provincial levels, predominantly shape the HB-HTA approach, determining a contingency model of HB-HTA. Crossing the two variables, four options have emerged: integrated specialized HTA unit, stand-alone HTA unit, integrated-essential HTA, independent group unit.

Conclusions: No one-best-way approach can be used for HTA at the hospital level. Rather, the characteristics of HTA models depend on many contextual factors. Such conceptualization may aid the diffusion of HB-HTA to inform managerial decision making and clinical practice.

Keywords

Technology assessmentBiomedical [N03.880]Organizations [N03.540]Hospitals [N02.278.421]Organizational case studies [N03.349.380.710]
Type
Policy
Information
International Journal of Technology Assessment in Health Care , Volume 34 , Issue 2 , 2018 , pp. 205 - 211
Copyright
Copyright © Cambridge University Press 2018 

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References

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