Exploring the challenges of developing hospital-based health technology assessment in Iran: a qualitative study.

IF 3.2 2区医学 Q1 HEALTH POLICY & SERVICES

Health Research Policy and Systems Pub Date : 2026-04-16 DOI:10.1186/s12961-026-01475-4

Meysam Behzadifar, Bardia Talebzadeh, Afshin Aalipour, Ahad Bakhtiari, Samad Azari, Mohammad Yarahmadi, Maryam Nematkhah, Aidin Aryankhesal, Banafsheh Darvishi Teli, Masoud Behzadifar, Rok Hren

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引用次数: 0

Abstract

Background: Hospital-based Health Technology Assessment (HB-HTA) is increasingly recognized as a strategy to support evidence-informed decision-making at the hospital level, particularly in resource-constrained settings. This study explored the challenges of developing HB-HTA in Iran from the perspectives of health system experts.

Methods: This qualitative descriptive study was conducted from July 2023 to February 2024. Data were collected through in-depth, semi-structured interviews with 26 health system experts selected via purposive sampling and supplemented with snowball sampling. Data were analysed using thematic analysis following Braun and Clarke's six-phase framework, supported by MAXQDA version 10 software. Credibility was enhanced through member checking with five participants outside the research team, investigator triangulation involving four researchers with expertise in health policy and HTA and consensus-based resolution of coding disagreements.

Results: Analysis identified five main themes and 12 subthemes describing barriers to HB-HTA development in Iran. The themes included structural and organizational challenges, resource limitations, cultural and attitudinal barriers, knowledge and capacity gaps and external systemic constraints. Findings highlighted the lack of institutionalization of HB-HTA, inadequate policy support, limited trained personnel, resistance among clinicians, weak research culture, centralized governance and poor stakeholder collaboration.

Conclusions: The study provides critical insights into the multifaceted challenges hindering HB-HTA in Iran. The findings are valuable for policymakers, hospital managers and healthcare professionals by offering practical guidance to strengthen institutional capacity, improve evidence-informed decision-making and advance HTA integration into hospital systems. Addressing these barriers through targeted reforms and inclusive strategies could enhance efficiency, equity and quality of care.

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探索在伊朗发展医院卫生技术评估的挑战：一项定性研究。

背景：基于医院的卫生技术评估（HB-HTA）越来越被认为是一种支持医院一级循证决策的策略，特别是在资源受限的情况下。本研究从卫生系统专家的角度探讨了在伊朗发展HB-HTA的挑战。方法：本研究于2023年7月至2024年2月进行定性描述性研究。通过对26名卫生系统专家进行深入的半结构化访谈收集数据，这些专家是通过有目的抽样选择的，并辅以滚雪球抽样。数据分析采用主题分析，遵循Braun和Clarke的六阶段框架，由MAXQDA version 10软件支持。通过与研究小组以外的五名参与者进行成员核查、涉及四名具有卫生政策和HTA专业知识的研究人员的调查员三角测量以及基于共识的编码分歧解决方案，提高了可信度。结果：分析确定了伊朗HB-HTA发展的5个主要主题和12个次要主题。主题包括结构和组织挑战、资源限制、文化和态度障碍、知识和能力差距以及外部系统限制。研究结果突出表明，乙肝- hta缺乏制度化、政策支持不足、培训人员有限、临床医生抗拒、研究文化薄弱、集中治理和利益相关者协作不良。结论：该研究为在伊朗阻碍HB-HTA的多方面挑战提供了重要见解。研究结果为加强机构能力、改善循证决策和推进HTA融入医院系统提供了实用指导，对政策制定者、医院管理人员和卫生保健专业人员具有重要价值。通过有针对性的改革和包容性战略解决这些障碍，可以提高效率、公平和护理质量。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Health Research Policy and Systems HEALTH POLICY & SERVICES-

CiteScore

7.50

自引率

7.50%

发文量

124

审稿时长

27 weeks

期刊介绍： Health Research Policy and Systems is an Open Access, peer-reviewed, online journal that aims to provide a platform for the global research community to share their views, findings, insights and successes. Health Research Policy and Systems considers manuscripts that investigate the role of evidence-based health policy and health research systems in ensuring the efficient utilization and application of knowledge to improve health and health equity, especially in developing countries. Research is the foundation for improvements in public health. The problem is that people involved in different areas of research, together with managers and administrators in charge of research entities, do not communicate sufficiently with each other.