Greenberg Dan, Pliskin Joseph S, Peterburg Yitzhak
Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Int J Technol Assess Health Care. 2003 Winter;19(1):194-201. doi: 10.1017/s0266462303000187.
This preliminary study had two objectives: a) charting the considerations relevant to decisions about acquisition of new medical technology at the hospital level; and b) creating a basis for the development of a research tool that will examine the function of the Israeli health system in assessment of new medical technologies.
A comprehensive literature review and in-depth interviews with decision makers at different levels allowed formulation of criteria considered by decision makers when they decide to purchase and use (or disallow the use) of new medical technology. The resulting questionnaire was sent to medical center directors, along with a letter explaining the goals of the study. The questionnaire included 31 possible considerations for decision making concerning the acquisition of new medical technology by medical centers. The interviewees were asked to indicate the relevance of each consideration in the decision-making process.
The most relevant criteria for the adoption of new technologies related to the need for a large capital investment, clinical efficacy of the technology as well as its influence on side effects and complication rates, and a formal approval by the Ministry of Health. Most interviewees stated that pressures exerted by the industry, by patients, or by senior physicians in the hospital are less relevant to decision making. Very small and usually not statistically significant differences in the ranking of hospital directors were found according to the hospitals' ownership, size, or location.
The present study is a basis for a future study that will map and describe the function of hospital decision makers within the area of new technology assessment and the decision-making process in the adoption of new healthcare technologies.
本初步研究有两个目标：a）梳理与医院层面购置新医疗技术决策相关的考量因素；b）为开发一种研究工具奠定基础，该工具将考察以色列卫生系统在评估新医疗技术方面的功能。
通过全面的文献综述以及对不同层面决策者的深入访谈，得以制定出决策者在决定购买和使用（或禁止使用）新医疗技术时所考虑的标准。随后将生成的问卷发送给医疗中心主任，并附上一封解释研究目标的信件。问卷包含了医疗中心在购置新医疗技术决策时可能考虑的31个因素。受访者被要求指出每个因素在决策过程中的相关性。
采用新技术最相关的标准涉及大量资本投资的需求、技术的临床疗效及其对副作用和并发症发生率的影响，以及卫生部的正式批准。大多数受访者表示，行业、患者或医院资深医生施加的压力与决策的相关性较小。根据医院的所有权、规模或位置，医院主任的排名存在非常小且通常无统计学意义的差异。
本研究是未来一项研究的基础，该研究将描绘和描述医院决策者在新技术评估领域的功能以及采用新医疗技术的决策过程。
