Lessa Fernanda, Ferraz Marcos Bosi
Division of Health Economics and Healthcare Management, Department of Medicine, Universidade Federal de São Paulo, São Paulo, Brazil.
Rev Panam Salud Publica. 2017 Jun 8;41:e25. doi: 10.26633/RPSP.2017.25.
To describe, analyze, and compare the opinions of decisionmakers involved in the health technology assessment (HTA) process in Brazil in 2011.
A cross-sectional study was conducted using a structured questionnaire to evaluate the opinions of a convenience sample of health care professionals from both the public and private health care systems (HCS). The survey collected demographic data for each respondent along with their input on national regulations. Data analysis included descriptive statistics, including chi-square tests to compare groups.
Of the 200 completed questionnaires, 65% of the respondents were 31-50 years of age; 36% were HCS managers, 49.3% from the public and 50.7% from the private system. The majority of respondents (85%) considered the time permitted for submission of new technology to be inadequate; 88% also stated that the composition of the evaluation committee needed improvement. Respondents from the private health system more frequently stated that submission times were inappropriate (P = 0.019) and that the deadline for a decision by the committee should be defined (P = 0.021), with a maximum of no more than 180 days / 6 months (P < 0.001).
Respondents indicated that the HTA process should be improved to meet their expectations. Given that new legislation has been enacted to continuously accept submissions, to make decisions within 180 days, and to expand the committee to represent more stakeholders, most of the respondents concerns have been addressed. This study is valuable as an historical analysis of HTA process improvement. Further surveys are needed to track the new HTA process, its application, and its contribution to health care needs in Brazil.
描述、分析和比较2011年巴西卫生技术评估(HTA)过程中决策者的意见。
采用横断面研究,使用结构化问卷评估来自公共和私营医疗保健系统(HCS)的便利样本医疗保健专业人员的意见。该调查收集了每位受访者的人口统计学数据以及他们对国家法规的意见。数据分析包括描述性统计,包括用于比较组别的卡方检验。
在200份完整问卷中,65%的受访者年龄在31至50岁之间;36%是HCS经理,49.3%来自公共系统,50.7%来自私营系统。大多数受访者(85%)认为提交新技术的时间不足;88%的受访者还表示评估委员会的组成需要改进。来自私营医疗系统的受访者更频繁地表示提交时间不合适(P = 0.019),并且委员会应确定决策期限(P = 0.021),最长不超过180天/6个月(P < 0.001)。
受访者表示HTA过程应加以改进以满足他们的期望。鉴于已颁布新立法以持续接受提交材料、在180天内做出决策并扩大委员会以代表更多利益相关者,大多数受访者的担忧已得到解决。作为对HTA过程改进的历史分析,本研究具有价值。需要进一步开展调查以跟踪巴西新的HTA过程、其应用及其对医疗保健需求的贡献。