While “how to perform” a rigorous Health Technology Assessment (HTA) at the institutional level is well established (1), very little has been experienced for empirically approaching an HTA in hospitals: no scientific evidence is available concerning the correct organizational model, to maximise and to improve the functioning, the performance and the effectiveness of the HTA units (2).

This study aims at crystallizing those design options that may positively contribute to the HTA units’ effectiveness (quality) and/or to the efficiency (timely) (3).

After the collection of qualitative data from ninety-five healthcare professionals by means of ad hoc questionnaires and interviews, a hierarchical sequential linear regression model was conducted to verify the existence of HTA units determinants. Size, multidisciplinary, trust among members, HTA previous skills and organizational support were the variables investigated, determining team performance.

A greater size and the presence of different specialities within the working unit positively influenced effectiveness, even if they spent more time to complete the assessment. Trust, previous HTA skills and organizational support played a key role in team performance. Size and previous HTA skills most explained the variance of team effectiveness (R2 = .317; Adjusted R2 = .249). The five investigated variables presented a higher explanatory nature regarding team efficiency (R2 = .246; Adjusted R2 = .165).

The study suggested the creation of multi-dimensional and multi-disciplinary HTA units to increase their effectiveness. HTA units should be monitored by the hospital management board, because an excessive increase in multi-disciplinary and size could determine inefficiency. Trust within members and the attendance of HTA training course improve performance. According to these results, the study gave solutions both to the scholars of HTA and to hospitals strategic management boards, paving the way to the determination of a more efficient and effective HTA units composition.