Novaes Hillegonda Maria Dutilh, Elias Flávia Tavares Silva
Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brasil.
Centro de Desenvolvimento Tecnológico em Saúde, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil.
Cad Saude Publica. 2013 Nov;29 Suppl 1:S7-16. doi: 10.1590/0102-311x00008413.
Policies for scientific development and knowledge production in health have increased in recent decades. In Brazil, incentives for research, development, and innovation have been part of the National Health Act since 1990, and science and technology policies for health, including health technology assessment (HTA), have been implemented since 1994, as in many other countries. The emphasis is now on impact evaluation of HTA policies in the incorporation of technologies by health services and systems. The article presents a case study of HTA utilization in decision-making processes in the Brazilian Ministry of Health, analyzing participation by the Department of Science and Technology (DECIT), responsible for the production of assessments used in the Commission on Technology Incorporation (CITEC) of the Ministry of Health from 2008 to 2010. CITEC used 103 assessments in its decisions during this period, of which DECIT produced 80%. Nearly all were literature reviews on therapeutic technologies. An increase in knowledge production was observed. A methodological and political learning process appears to have occurred in the use of HTA, but its impact on Brazilian Unified National Health System remains unclear.
近几十年来，卫生领域的科学发展和知识生产政策有所增加。在巴西，自1990年以来，对研究、开发和创新的激励措施一直是《国家卫生法》的一部分，与许多其他国家一样，自1994年起实施了包括卫生技术评估（HTA）在内的卫生科技政策。现在的重点是评估HTA政策对卫生服务和系统采用技术的影响。本文介绍了巴西卫生部决策过程中HTA利用情况的案例研究，分析了负责评估工作的科学技术司（DECIT）的参与情况，该司在2008年至2010年期间为卫生部技术纳入委员会（CITEC）提供评估。在此期间，CITEC在其决策中使用了103份评估报告，其中80%由DECIT提供。几乎所有报告都是关于治疗技术的文献综述。知识产量有所增加。在HTA的使用中似乎发生了方法和政策学习过程，但其对巴西统一国家卫生系统的影响仍不明确。
