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IMPACT OF HEALTH TECHNOLOGY ASSESSMENT REPORTS ON HOSPITAL DECISION MAKERS – 10-YEAR INSIGHT FROM A HOSPITAL UNIT IN SHERBROOKE, CANADA: IMPACT OF HEALTH TECHNOLOGY ASSESSMENT ON HOSPITAL DECISIONS

Published online by Cambridge University Press:  19 July 2018

Thomas G. Poder
Affiliation:
UETMIS, CIUSSS de l'Estrie - CHUS, Sherbrooke, Department of Family Medicine and Emergency Medicine, Faculty of Medicine and Health Sciences, University of Sherbrooke, Centre de recherche du Centre hospitalier universitaire de Sherbrooke (CRCHUS), Department of Economics, École de Gestion, University of Sherbrookethomas.poder@usherbrooke.ca
Christian A. Bellemare
Affiliation:
UETMIS, CIUSSS de l'Estrie - CHUS, Sherbrooke
Suzanne K. Bédard
Affiliation:
UETMIS, CIUSSS de l'Estrie - CHUS, Sherbrooke
Jean-François Fisette
Affiliation:
UETMIS, CIUSSS de l'Estrie - CHUS, Sherbrooke
Pierre Dagenais
Affiliation:
UETMIS, CIUSSS de l'Estrie - CHUS, Sherbrooke, Centre de recherche du Centre hospitalier universitaire de Sherbrooke (CRCHUS), Department of Medicine, Faculty of Medicine and Health Sciences, University of Sherbrooke

Abstract

Objectives:

The overarching goal of this research was to (i) evaluate the impact of reports with recommendations provided by a hospital-based health technology assessment (HB-HTA) unit on the local hospital decision-making processes and implementation activities and (ii) identify the underlying factors of the nonimplementation of recommendations.

Methods:

All reports produced by the HB-HTA unit between December 2003 and March 2013 were retrieved, and hospital decision makers who requested these reports were solicited for enrolment. Participants were interviewed using a mixed design survey.

Results:

Twenty reports, associated with fifteen decision makers, fulfilled the study criteria. Nine decision makers accepted to participate, corresponding to thirteen reports and twenty-three recommendations. Of the twenty-three recommendations issued, 65 percent were implemented, 9 percent were accepted for implementation but not implemented, and 26 percent were declined. In terms of the utility of each report to guide decision makers, 92 percent of the reports were considered in the decision-making process; 85 percent had one or more recommendations adopted; and 77 percent had recommendations implemented. The most frequently mentioned reasons for nonimplementation were related to contextual factors (64 percent), production/diffusion process factors (14 percent), content/format factors (14 percent), or other factors (9 percent). Among the contextual factors, the complexity of the changes (i.e., administrative reasons), budget and resources constraints, failure to identify administrative responsibility to carry out the recommendation, and nonpriority status of the HTA recommendation, were provided.

Conclusions:

This study highlights that although HB-HTA reports are useful to hospital managers in their decision-making processes, certain barriers such as contextual factors need to be better addressed to improve HB-HTA efficiency and usefulness.

Type
Assessment
Copyright
Copyright © Cambridge University Press 2018 

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Footnotes

The authors acknowledge the contributions of all participants who diligently accepted to take part of this study. The authors thank Martin Coulombe and Renald Lemieux for their valuable suggestions on the validation of our questionnaire. We acknowledge Louise Corbeil, Sylvain Bernier, and Linda Pinsonneault for their assistance and comments. We also thank the Unité de Recherche Clinique et Épidémiologique (URCE) of the Centre de recherche du CHU de Sherbrooke for their support in coordinating the preparation and revisions of this manuscript. Thomas G. Poder is member of the FRQS-funded Centre de recherche du CHUS (CRCHUS). This project was funded by the operating budget of the UETMIS of the CHUS.

References

REFERENCES

1.Banta, D. What is technology assessment? Int J Technol Assess Health Care. 2009;25:79.Google Scholar
2.Abelson, J, Giacomini, M, Lehoux, P, et al. Bringing “the public” into health technology assessment and coverage policy decisions: From principles to practice. Health Policy. 2007;82:3750.Google Scholar
3.Hua, M, Boonstra, T, Kelly, PJ, et al. Quality of health technology assessment reports prepared for the Medical Services Advisory Committee. Int J Technol Assess Health Care. 2016;32:315323.Google Scholar
4.Gagnon, M-P, Desmartis, M, Poder, T, et al. Effects and repercussions of local/hospital-based health technology assessment (HTA): A systematic review. Syst Rev. 2014;3:129.Google Scholar
5.Attieh, R, Gagnon, M-P. Implementation of local/hospital-based health technology assessment initiatives in low- and middle-income countries. Int J Technol Assess Health Care. 2012;28:445451.Google Scholar
6.Kahveci, R. Editorial: HB-HTA in low- and middle-income countries. Int J Hosp-Based Health Technol Assess. 2017;1:12.Google Scholar
7.Dupouy, C, Gagnon, M. The influence of hospital-based HTA on technology acquisition decision. Int J Hosp-Based Health Technol Assess. 2016;1:1928.Google Scholar
8.Hailey, D. Commentary on “The influence of hospital-based HTA on technology acquisition decision.” Int J Hosp-Based Health Technol Assess. 2016;1:2930.Google Scholar
9.CADTH. Informing decision-makers about emerging medical technologies, policies, practices, and research. Health technology update. https://www.cadth.ca/media/pdf/hta_htupdate_issue-13_e.pdf (accessed June 7, 2018).Google Scholar
10.Gagnon, MP, Ben AbdelJelil, A, Desmartins, M, et al. Opportunities to promote efficiency in hospital decision-making through the use of health technology assessment. http://www.cfhi-fcass.ca/sf-docs/default-source/commissioned-research-reports/Gagnon-Dec2011-EN.pdf?sfvrsn=0 (accessed June 7, 2018).Google Scholar
11.Bellemare, CA, Fisette, J-F, Poder, TG, et al. The Health Technology Assessment Unit of the Centre hospitalier universitaire de Sherbrooke (Canada). In: Sampietro-Colom, L, Martin, J, eds. Hospital-based health technology assessment. The next frontier for health technology assessment. Switzerland: Adis; 2016:185–200.Google Scholar
12.Lafortune, L, Farand, L, Mondou, I, et al. Assessing the performance of health technology assessment organizations: A framework. Int J Technol Assess Health Care. 2008;24:7686.Google Scholar
13.Parsons, T. Social systems and the evolution of action theory. New York: Free Press; 1977.Google Scholar
14.Donabedian, A. Aspects of medical care administration. Cambridge, MA: Harvard University Press; 1973.Google Scholar
15.Donabedian, A. The quality of care. How can it be assessed? JAMA. 1988;260:17431748.Google Scholar
16.Steuten, L, Vrijhoef, B, Severens, H, et al. Are we measuring what matters in health technology assessment of disease management? Systematic literature review. Int J Technol Assess Health Care. 2006;22:4757.Google Scholar
17.McDonald, K, Sundaram, V, Bravata, D, et al. Closing the quality gap: A critical analysis of quality improvement strategies (Vol. 7 - Care Coordination). Rockville, MD: Agency for Healthcare Research and Quality. 2007.Google Scholar
18.Busse, R, Orvain, J, Velasco, M, et al. Best practice in undertaking and reporting health technology assessments. Working group 4 report. Int J Technol Assess Health Care. 2002;18:361422.Google Scholar
19.Schumacher, I, Zechmeister, I. Assessing the impact of health technology assessment on the Austrian healthcare system. Int J Technol Assess Health Care. 2013;29:8491.Google Scholar
20.Hailey, D. Profile of an HTA program. The AHFMR Health Technology Assessment Unit, 2002–2003. Alberta: Alberta Heritage Foundation for Medical Research; 2004.Google Scholar
21.Bodeau-Livinec, F, Simon, E, Montagnier-Petrissans, C, et al. Impact of CEDIT recommendations: An example of health technology assessment in a hospital network. Int J Technol Assess Health Care. 2006;22:161168.Google Scholar
22.Gerhardus, A, Dorendorf, E, Rottingen, J-A, et al. What are the effects of HTA reports on the health system? Evidence from the research literature. In: Garrido, M, Kristensen, F, Nielsen, C, et al. , eds. Health technology assessment and health policy-making in Europe. Current status, challenges and potential. Observatory Studies Series N°14. Brussels: European Observatory on Health Systems and Policies; 2008:109137.Google Scholar
23.McGregor, M. The impact of reports of the technology assessment unit of the McGill University Health Centre. Montreal (Canada): Technology Assessment Unit (TAU) of the McGill University Health Centre (MUHC). Report no. 65. 2012. https://secureweb.mcgill.ca/tau/sites/mcgill.ca.tau/files/muhc_tau_2012_65_impact.pdfGoogle Scholar
24.Berelson, B. Content analysis in communication research. In: Glencoe, I, ed. Glencoe IL: Free Press; 1952.Google Scholar
25.Silverman, D. Doing qualitative research. A practical handbook. (4th ed). Thousand Oaks, C: SAGE; 1999.Google Scholar
26.Andreani, JC, Conchon, F. Méthodes d'analyse et d'interprétation des études qualitatives: état de l'art en marketing. In: International Marketing Trends Conference in Paris; 2013.Google Scholar
27.Grenon, X, Pinget, C, Wasserfallen, J-B. Hospital-based health technology assessment (HB-HTA): A 10-year survey at one unit. Int J Technol Assess Health Care. 2016;32:116121.Google Scholar
28.Cram, N, Groves, J, Foster, L. Technology assessment--A survey of the clinical engineer's role within the hospital. J Clin Eng. 1997;22:373382.Google Scholar
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