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A 10-YEAR HOSPITAL-BASED HEALTH TECHNOLOGY ASSESSMENT PROGRAM IN A PUBLIC HOSPITAL IN ARGENTINA

Published online by Cambridge University Press:  08 May 2015

Graciela Demirdjian
Graciela Demirdjian*
Affiliation:
HTA Coordinator Hospital Nacional de Pediatría “Juan P. Garrahan” and UCEETS (Unidad Coordinadora de Evaluación y Ejecución de Tecnologías Sanitarias, Ministerio de Salud de la Nación)gdemir@intramed.net
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Abstract

Objectives: To describe the first hospital-based health technology assessment (HTA) program in a public hospital in Argentina, and report some clinical, educational, economic and organizational results after 10 years of its implementation.

Methods: A hospital-based HTA program was created in March 2001 at Hospital Garrahan (Buenos Aires, Argentina), a national pediatric facility with a self-managed budget. Its main goal is to promote a rational and evidence-based technologic development. The program consists of HTA reports for technology acquisition, clinical practice guidelines (CPG), capacity building in research and management, and technical support for health services research (HSR). The evaluation cycle comprises: prioritization, evidence synthesis, dissemination and monitoring. We report program performance, comment educational and organizational effects, and discuss unresolved issues and future challenges.

Results: During the first 10 years the program produced 18 HTA reports on drugs (6 = 33 percent), therapeutic (6 = 33 percent), preventive (2 = 11 percent) or diagnostic (2 = 11 percent) procedures and institutional programs (3 = 17 percent). The scope covered effectiveness (12 = 67 percent), safety (10 = 56 percent), budget impact (6 = 33 percent), cost-effectiveness (2 = 11 percent) and organizational impact (3 = 17 percent). Mean time from request to report was 10 months. Eleven pediatric CPGs were submitted to expert consensus and disseminated for full-text Web access. A 1-year course on research and management was completed by 225 professionals in 6 years, and twenty-two projects for HSR were coached.

Conclusions: Our experience shows that an HTA program is both feasible and useful in a public hospital of a developing country. Promotion of hospital-based HTA, professional integration in HTA activities and network collaboration to discuss unresolved issues with colleagues can multiply the benefits and optimize the use of hospital budgets.

Keywords

Biomedical technology assessmentPractice guidelinesHospitalCostsPediatrics
Type
Policies
Information
International Journal of Technology Assessment in Health Care , Volume 31 , Issue 1-2 , 2015 , pp. 103 - 110
Copyright
Copyright © Cambridge University Press 2015 

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References

REFERENCES

1. Batista, RN, Hodge, MJ. The evolving paradigm of health technology assessment: Reflections for the millennium. Can Med Assoc J. 1999;160:1464–1467.Google Scholar
2. McDonald, IG. Quality assurance and technology assessment: Pieces of a larger puzzle. J Qual Clin Pract. 2000;20:87–94.Google Scholar
3. Fleisher, LA, Srinivas, M, Roizen, MF. Medical technology assessment: An overview. Anaesth Analg. 1998;87:1271–1282.Google Scholar
4. Goodman, CS, Ahn, R. Methodological approaches of health technology assessment. Int J Med Inform. 1999;56:97–105.Google Scholar
5. Sheldon, TA. Quality: Link with effectiveness. Qual Health Care. 1994;3 (Suppl):1–5.Google Scholar
6. Infante, A. Health technology assessment in Latin America and the Caribbean countries. Health Technol Assess. 1998;:8–10.Google Scholar
7. Departamento de Ciência e Tecnologia, Secretaria de Ciência, Tecnologia e Insumos Estratégicos, Ministério da Saúde. Consolidação da área de avaliação de tecnologias em saúde no Brasil [Consolidation of health technology assessment in Brazil]. Rev Saude Publica. 2010;44:381–383.Google Scholar
8. Juzwishin, D, Olmstead, D, Menon, D. Hospital-based technology assessment programmes: Two Canadian examples. World Hosp Health Serv. 1996;32:2–9.Google Scholar
9. Steinberg, EP, Graziano, S. Integrating technology assessment and medical practice evaluation into hospital operations. Qual Rev Bull. 1990;16:218–222.CrossRefGoogle ScholarPubMed
10. McGregor, M, Brophy, JM. End-user involvement in health technology assessment (HTA) development: A way to increase impact. Int J Technol Assess Health Care. 2005;21:263–267.Google Scholar
11. Vestergaard, M, Ehlers, L, Kidholm, K, et al. Introduction to mini-HTA: A management and decision support tool for the hospital service. Danish Center for Evaluation and HTA. 2005. http://www.sst.dk/publ/Publ2005/cemtv/Mini_mtv/Introduction_mini_hta.pdf.Google Scholar
12. Briones, E, Loscertales, M, Pérez Lozano, MJ, en nombre del Grupo, GANT. Proyecto GANT: Metodología de desarrollo y estudio preliminar. Sevilla, Agencia de Evaluación de Tecnologías Sanitarias de Andalucía. 1999.Google Scholar
13. Drummond, M, Weatherly, H. Implementing the findings of health technology assessments. If the CAT got out of the bag, can the TAIL wag the dog? Int J Technol Assess Health Care, 2000;16:1–12.Google Scholar
14. Goodman, GR. Group processes of decision making for hospital-based technology assessment committees. Biomed Instrum Technol. 1995;29:410–417.Google Scholar
15. EUnetHTA Work Package 8. EUnetHTA handbook on health technology assessment capacity building. Barcelona (Spain): Catalan Agency for Health Technology Assessment and Research. Catalan Health Service. Department of Health Autonomous Government of Catalonia; 2008.Google Scholar
16. Hailey, D. Elements of effectiveness for health technology assessment programs. HTA Initiative #9. Edmonton: Alberta Heritage Foundation for Medical Research; 2003.Google Scholar
17. Umscheid, CA, Williams, K, Brennan, PJ. Hospital-based comparative effectiveness centers: Translating research into practice to improve the quality, safety and value of patient care. J Gen Intern Med. 2010;25:1352–1355.Google Scholar
18. Rogers, TL. Hospital-based technology assessment. J Clin Eng. 2002;27:276–279.Google Scholar
19. Martelli, N, Lelong, AS, Prognon, P, Pineau, J. Hospital-based health technology assessment for innovative medical devices in university hospitals and the role of hospital pharmacists: Learning from international experience. Int J Technol Assess Health Care. 2013;29:185–191.Google Scholar
20. Cicchetti, A, Marchetti, M, Dibidino, R, Corio, M. Hospital based health technology assessment world-wide survey. Health Technology Assessment International, Hospital Based Health Technology Assessment Sub-Interest Group. 2008.Google Scholar
21. Catananti, C, Cicchetti, A, Marchetti, M. Hospital-based health technology assessment: The experience of Agostino Gemelli University Hospital's HTA Unit. Ital J Public Health. 2005;3:23–28.Google Scholar
22. Sampietro-Colom, L, Morilla-Bachs, I, Gutierrez-Moreno, S, Gallo, P. Development and test of a decision support tool for hospital health technology assessment. Int J Tech Assess Health Care. 2012;28:460–465.Google Scholar
23. Battista, RN, Déry, V, Jacob, R, et al. L’évaluation des technologies et des modes d’intervention en santé dans les hôpitaux universitaires [Health technology and healthcare intervention assessment at university hospitals]. Montréal: AETMIS, 2003.Google Scholar
24. Bodeau-Livinec, F, Simon, E, Montagnier-Petrissans, C, Joël, ME, Féry-Lemonnier, E. Impact of CEDIT recommendations: An example of health technology assessment in a hospital network. Int J Technol Assess Health Care. 2006;22:161–168.Google Scholar
25. Lafortune, L, Farand, L, Mondou, I, Sicotte, C, Battista, R. Assessing the performance of health technology assessment organizations: A framework. Int J Technol Assess Health Care. 2008;24:76–86.Google Scholar