驾驭变革:各机构卫生技术评估改革的比较分析--过程、驱动因素和相互依存关系。

IF 2.6 4区 医学 Q2 HEALTH CARE SCIENCES & SERVICES
Gayathri Kumar, Priscila Radu, Patricia Cubi-Molla, Martina Garau, Eleanor Bell, Jia Pan, Ramiro Gilardino, Julie Van Bavel, Agnes Brandtmüller, Katherine Nelson, Melinda Goodall
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引用次数: 0

摘要

目的:卫生技术评估(HTA)是许多国家卫生保健决策的重要组成部分。HTA机构的方法和流程(M&P)的变化会影响患者获得治疗的时间和程度。已发表的文献关注的是HTA机构采用的不同并购策略,而不是这些策略是如何随着时间的推移而产生的。我们的研究调查了欧洲、亚太地区和北美地区一系列HTA机构的关键HTA改革,并探讨了这些改革的驱动因素和相互依赖性。方法:我们对14家HTA机构的M&P指南及其后续修改进行了有针对性的文献回顾。我们通过29次与特定国家专家的半结构化访谈补充并验证了初步调查结果。我们使用分析工具来创建流程图、主动性和影响力网络以及HTA机构集群。结果:我们发现,在HTA机构中,导致M&P改革的过程遵循类似的步骤。改革的三个最重要的驱动因素是:其他国家的卫生管理局实践和指导方针;机构所在国家的医疗保健政策、法律和政治环境;以及HTA机构本身在评估过程中遇到的挑战。国际合作有可能加速HTA系统的发展和改革的实施。结论:PBAC(澳大利亚)、CDA-AMC(加拿大)、NICE(英国)、IQWiG(德国)和ZIN(荷兰)是HTA改革的催化剂和具有国际影响力的机构。只要确保利益攸关方在早期阶段广泛参与,国际合作可能是加速变革的有效途径。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Navigating change: a comparative analysis of health technology assessment reforms across agencies - processes, drivers, and interdependencies.

Objectives: Health technology assessment (HTA) is a critical part of healthcare decision making in many countries. Changes in Methods and Processes (M&P) of HTA agencies can affect the time and degree of patient access to treatments. Published literature focuses on the different M&P adopted by HTA agencies, rather than on how these have come about over time. Our study investigates key HTA reforms and explores their drivers and interdependencies in a set of HTA agencies in Europe, Asia-Pacific, and North America.

Methods: We conducted a targeted literature review on M&P guidelines and subsequent changes to those, for 14 HTA agencies. We supplemented and validated initial findings with 29 semi-structured interviews with country-specific experts. We used analytical tools to create process maps, proactivity and influence networks, and clusters of HTA agencies.

Results: We found that processes leading to M&P reforms follow similar steps across HTA agencies. The three most important drivers to reforms were HTA practice and guidelines in other countries; the healthcare policy, legal, and political context within the agency's country; and experience of challenges in the assessment by the HTA body itself. International collaborations have the potential to accelerate the evolution of HTA systems and the implementation of reforms.

Conclusion: We identified PBAC (Australia), CDA-AMC (Canada), NICE (England), IQWiG (Germany), and ZIN (the Netherlands) as HTA agencies that are catalysts of HTA reforms as well as internationally influential. International collaborations may represent a useful route to accelerate changes as long as they ensure wide stakeholder engagement at an early stage.

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来源期刊
International Journal of Technology Assessment in Health Care
International Journal of Technology Assessment in Health Care 医学-公共卫生、环境卫生与职业卫生
CiteScore
4.40
自引率
15.60%
发文量
116
审稿时长
6-12 weeks
期刊介绍: International Journal of Technology Assessment in Health Care serves as a forum for the wide range of health policy makers and professionals interested in the economic, social, ethical, medical and public health implications of health technology. It covers the development, evaluation, diffusion and use of health technology, as well as its impact on the organization and management of health care systems and public health. In addition to general essays and research reports, regular columns on technology assessment reports and thematic sections are published.
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