Technology Assessment In Health Care From Theory To Practice

Most of the material in this book was presented to an international symposium on technology assessment in health care which took place in Jerusalem in january 1994. Each country has its own health care system, its own philosophy, history, values and even code of ethics. The purpose of this book is to display the way health technology policy operates today in different countries, with emphasis on disparities and similarities. It concentrates on the practical aspects of applying technology assessment in health care, at both local and national levels. The book is divided in four sections: 1) The role of technology assessment in health care reform. How should technology be used? national perspectives. 2) The diffusion of medical technology: methodological differences. 3) The role of providers and insurers in technology assessment. 4) The role of professional organizations, universities and research centers in technology.

This book provides a robust set of health economic principles and methods to inform societal decisions in relation to research, reimbursement and regulation (pricing and monitoring of performance in practice). We provide a theoretical and practical framework that navigates to avoid common biases and suboptimal outcomes observed in recent and current practice of health economic analysis, as opposed to claiming to be comprehensive in covering all methods. Our aim is to facilitate efficient health system decision making processes in research, reimbursement and regulation, which promote constrained optimisation of community outcomes from a societal perspective given resource constraints, available technology and processes of technology assessment. Importantly, this includes identifying an efficient process to maximize the potential that arises from research and pricing in relation to existing technology under uncertainty, given current evidence and associated opportunity costs of investment. Principles and methods are identified and illustrated across health promotion, prevention and palliative care settings as well as treatment settings. Health policy implications are also highlighted.

To accompany the hugely sccessful 'Methods for Economic Evaluation of Health Care Programmes 2e', this book is a thorough and rigourous discussion of the methodological principles and recent advances in the rapidly advancing field of theory and practice of economic evaluation in health care. Written by an internationally acclaimed group of authors, the book provides an in-depth discussion of the latest theoretical advances and gives comprehensive reviews of the available literature. The book covers the main areas of economic evaluation, including the methods for measuring costs and outcomes, the collection of data alongside clinical studies, ways of handling uncertainty, discounting and issues relating to the transferability of economic data. It is an ideal book for those studying economic evaluation on postgraduate or professional courses in health economics or public health.

The problem of deciding which health care technologies to evaluate is urgent. With new technologies proliferating alongside steadily increasing health care costs, it is critical to discriminate among technologies to direct tests and treatments at those who can benefit the most. Given the vast number of clinical problems and technologies to be evaluated, the many months of work required to study just one problem, and the relatively few clinicians with highly developed analytic skills, institutions must set priorities for assessment. This book sets forth criteria and a method that can be used by public agencies such as the Office of Health Technology Assessment (in the U.S. Public Health Service) and by any private organization conducting such work to decide which technologies to assess or reassess.

This book analyses the factors that influence the development and implementation of Health Technology Assessment (HTA) from multiple perspectives. It investigates the development of HTA activities in decentralized countries with a specific focus on the analysis of healthcare professionals’ perceptions. Although these perceptions are highly relevant in terms of implementing HTA processes, especially at the local level, they are rarely captured, and require further investigation, which this book provides. In particular, HTA has been introduced as a support tool for reviewing and assessing the introduction and dissemination of healthcare technologies. The book discusses how individual and organisational factors affect knowledge production and translation, and their relevance in the context of HTA. Furthermore, it explores how HTA could be more successfully implemented in decentralized healthcare systems.

This book disentangles the issues in connection with the advancement of Health Technology Assessment (HTA) and its interface with health policy. It highlights the factors that should shape its progress in the near future. Interdisciplinary and critical views from a number of professionals are put together in a prescient order to cast some light and make recommendations as to the next steps HTA should take to be fit for purpose. A wealth of documents dealing with HTA have been published over the last three decades. HTA allegedly is one of the bedrocks of regulation and medical decision making. However, counter vailing visions contend that geographical variations in the role that HTA is actually playing within countries pinpoints specific room for improvement. Given our social preferences, cherry-picking HTA’s features and successes over the last decades moves it away from its possibility frontier. Some of the most noteworthy hindrances that HTA faces, in several countries, to making headway towards its consolidation as an efficient tool for regulation and decision making are as follows: insufficient resources, delays in assessment, inadequate priority setting, regulatory capture, public distrust, actual influence on regulatory decisions, the need for strengthening international cooperation and harmony, the lack of sound and consistent assessments of diagnostic tests, medical devices and surgical innovations and limited dissemination. Time has come for HTA to take a renewed stand. There is a pressing need to submit HTA to in-depth critical scrutiny.

Technology assessment can lead to the rapid application of essential diagnostic technologies and prevent the wide diffusion of marginally useful methods. In both of these ways, it can increase quality of care and decrease the cost of health care. This comprehensive monograph carefully explores methods of and barriers to diagnostic technology assessment and describes both the rationale and the guidelines for meaningful evaluation. While proposing a multi-institutional approach, it emphasizes some of the problems involved and defines a mechanism for improving the evaluation and use of medical technology and essential resources needed to enhance patient care.

This is the second book in the series of books that we edit on the Management of Medical Technology (MMT) published by Kluwer Academic Publishers. The fIrst book Managing Technology in Health Care offered a broad-brushed view of the topics involved in the new and exciting area of MMT that we have launched. A group of distinguished scholars contributed to the fIrst book. While working on the first book in the series, and on a variety of articles in MMT, we began to realize that there is an urgent need for a comprehensive and highly focused book which will introduce and define the area of MMT. In addition, we had just completed the two studies of MMT in American hospitals, and had a magnificent database fully analyzed. With three months left in the first author's sabbatical, and thanks to the encouragement from our editor at Kluwer, Gary Folven, we took to the task of writing this book. The merging in this book of the description of a new intellectual space, and the write-up of the results from our MMT studies have created a unique blend of very attractive reading material. The reader will find this book to be a fascinating adventure into a newly-created area of intellectual endeavor, coupled with fIndings about how the health care delivery system manages teclUlology. Regardless of the reader's background, this book will certainly be of interest, as it links the medical and business frameworks.