乌克兰医院目前采用的卫生技术方法

Olena Filiniuk, Mykhailo Babenko, Kostyantin Kosyachenko, Rabia Sucu
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引用次数: 0

摘要

该研究旨在收集有关当前决策方法的见解,并确定与乌克兰医院实施卫生技术有关的挑战和机遇。材料和方法。来自乌克兰不同地区三家公立医院的28名受访者参加了2022年9月至2023年3月期间进行的在线半结构化访谈。本研究的受访者包括各种各样的利益攸关方,包括总经理、医务主任、经济学家、采购部门代表、临床和诊断部门负责人、临床医生和药剂师。为了有效地指导面试过程,我们编制了一份全面的问卷。从受访者收集的数据进行分析和综合到结果和结论。结果。半结构化访谈研究一致地揭示了所有受访医院在采用新卫生技术方面的共同模式。引入这些技术的过程需要几个阶段,每个阶段都需要细致的规划、协调和各种利益相关者的积极参与。值得注意的是,在我们研究的所有医院中,来自同一专业的利益相关者始终参与同一决策阶段。乌克兰《公共采购法》概述了实施新卫生技术的技术阶段,这些阶段在乌克兰各医院已经确立。但是,在选择采购哪种卫生技术方面仍有改进的余地。目前的评估过程往往依赖于有限的信息来源,缺乏全面的文献综述或与现有实践或安慰剂的可靠比较。这种信息差距妨碍了作出考虑到所有相关因素的明智决定的能力。该研究还确定了未来在乌克兰实施医院卫生技术评估(HB-HTA)的具体挑战。面对这些挑战,需要在医院层面投资建设HTA专业知识,培养强有力的领导支持,提供专业人员培训,并建立健全的数据收集和管理系统。克服这些障碍对于医院加强其有效实施新卫生技术并就其利用作出知情决定的能力至关重要。结论。我们的研究表明,在乌克兰实施新的卫生技术所涉及的所有技术阶段都已确立。有人指出,在选择购买哪种新的保健技术的过程中还有改进的余地。这一阶段称为基于HTA的决策过程,需要在医院一级实施。我们的研究强调了在接受调查的医院中采用HB-HTA的明显兴趣和潜在益处。通过将HB-HTA整合到现有的实践和方法中,医院可以在引入新的卫生技术时显著提高其决策过程。迫切需要在乌克兰立法中引入"以医院为基础的卫生保健服务"一词,并在医院一级开始培训卫生保健服务专家
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Current approaches of health technologies introduction in Ukrainian hospitals
The study aimed to gather insights regarding current decision-making approaches and identify challenges and opportunities related to health technology implementation in Ukrainian hospitals. Materials and methods. A total of 28 respondents from three public hospitals across different regions of Ukraine participated in online semi-structured interviews conducted between September 2022 and March 2023. The respondents for this study encompassed a diverse range of stakeholders, including general managers, medical directors, economists, representatives from procurement departments, heads of clinical and diagnostic departments, clinicians, and pharmacists. To effectively guide the interview process, a comprehensive questionnaire was developed. The data collected from the respondents were analyzed and synthesized to results and conclusions. Results. The semi-structured interview study consistently revealed a common pattern in all the interviewed hospitals regarding the adoption of new health technologies. The process of introducing these technologies entails several stages, each demanding meticulous planning, coordination, and active engagement from various stakeholders. What stood out was that stakeholders from the same speciality were consistently involved in the same decision-making stage across all the hospitals we studied. The technical stages of implementing new health technologies, as outlined by the Law of Ukraine "On Public Procurement," are well-established in Ukrainian hospitals. However, there is room for improvement in selecting which type of health technology to procure. The current assessment process often relies on limited sources of information, lacking comprehensive literature reviews or robust comparisons with existing practices or placebos. This information gap hampers the ability to make well-informed decisions that account for all relevant factors. The study also identifies specific challenges for the future implementation of the Hospital Health Thechnology Assessment (HB-HTA) in Ukraine. These challenges necessitate investment in building HTA expertise at the hospital level, cultivating strong leadership support, providing professional staff training, and establishing robust data collection and management systems. Overcoming these obstacles is crucial for hospitals to bolster their capacity to effectively implement new health technologies and make informed decisions about their utilization. Conclusions. Our study has revealed that all the technical stages involved in implementing new health technologies in Ukraine are well established. It was observed that there is room for improvement in the process of selecting which new health technology to purchase. This stage, known as the decision-making process based on HTA, requires implementation at the hospital level. Our study highlights the evident interest and potential benefits associated with adopting HB-HTA in the hospitals under investigation. By integrating HB-HTA into existing practices and approaches, hospitals can significantly enhance their decision-making processes when introducing new health technologies. There is an urgent need to introduce the term "hospital-based HTA" into Ukrainian legislation, as well as to activate the training of HTA experts at the hospital level
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