Lehoux P, Blume S
University of Montreal.
J Health Polit Policy Law. 2000 Dec;25(6):1083-120. doi: 10.1215/03616878-25-6-1083.
In a growing number of countries, health technology assessment (HTA) has come to be seen as a vital component in policy making. Even though the assessment of the social, political, and ethical aspects of health technology is listed as one of its main objectives, in practice, the integration of such dimensions into HTA remains limited. Recent social scientific research on the inherently political nature of technology strongly supports such a comprehensive approach. The growing claims by and on behalf of consumer groups also suggest that HTA should be informed by a broader set of perspectives. Using the example of the cochlear implant in children, this essay compares the professed objectives of HTA with typical practice and explores possible explanations for the discrepancies observed. A second example, home telemonitoring for elderly persons, demonstrates how the types of evidence considered by HTA and the process through which assessments are produced may be reconsidered. We argue for the formal integration of the sociopolitical dimensions of health care technologies into assessments. The ability of HTA to more fully address important issues from a public policy point of view will increase by making explicit the sociopolitical nature of health care technologies.
在越来越多的国家，卫生技术评估（HTA）已被视为政策制定的重要组成部分。尽管对卫生技术的社会、政治和伦理方面的评估被列为其主要目标之一，但在实践中，将这些层面纳入HTA的程度仍然有限。最近关于技术本质上具有政治性的社会科学研究有力地支持了这种全面的方法。消费者团体自身以及代表他们提出的越来越多的主张也表明，HTA应该从更广泛的视角来考虑。本文以儿童人工耳蜗为例，将HTA宣称的目标与典型实践进行比较，并探讨观察到的差异的可能原因。第二个例子是老年人家庭远程监测，展示了如何重新考虑HTA所考虑的证据类型以及评估产生的过程。我们主张将医疗保健技术的社会政治层面正式纳入评估。通过明确医疗保健技术的社会政治性质，HTA从公共政策角度更全面地解决重要问题的能力将会增强。
