Department Community Health Sciences,O'Brien Institute for Public Health.
Department Community Health Sciences,O'Brien Institute for Public Health,Department of Critical Care Medicine.
Int J Technol Assess Health Care. 2018 Jan;34(2):212-217. doi: 10.1017/S0266462318000120. Epub 2018 Apr 4.
Health technology reassessment (HTR) is a policy process to manage health technologies throughout their lifecycle and ensure their ongoing optimal use. However, within an ever-evolving field, HTR is only one of many concepts associated with the optimization of health technologies. There is limited understanding of how other concepts and processes might differ and/or be interrelated. This study aims to describe the concepts underlying the various technology optimization processes and to reconcile their relationships within the HTR process.
A synthesis of the literature on approaches to HTR was completed. An inductive synthesis approach was completed to catalogue common concepts and themes. Expert stakeholders were consulted to develop a schematic to diagrammatically depict the relationships among concepts and frame them within the HTR process.
A practical schematic was developed. Common concepts and themes were organized under six major domains that address the following discussion questions: (i) what is the value of the existing technology?; (ii) what is the current utilization gap?; (iii) what are the available tools and resources?; (iv) what are the levers for change?; (v) what is the desired outcome?; and (vi) who are the foundational actors?
Using these six questions to frame the issues faced by HTR will advance the common understanding of HTR, as well as improve implementation of HTR initiatives. These questions will clearly identify the process required to move forward within a complex healthcare system.
卫生技术评估（HTR）是一个贯穿卫生技术全生命周期的政策过程，旨在确保其持续优化使用。然而，在这一不断发展的领域中，HTR 只是与优化卫生技术相关的众多概念之一。对于其他概念和流程可能存在哪些差异和/或相互关系，人们的理解有限。本研究旨在描述各种技术优化流程背后的概念，并协调它们在 HTR 流程中的关系。
对 HTR 方法的文献进行了综合分析。采用归纳综合方法对常见概念和主题进行分类。咨询了专家利益相关者，以制定一个示意图，以图示方式描绘概念之间的关系，并将其框定在 HTR 流程中。
开发了一个实用的示意图。常见概念和主题被组织在六个主要领域下，这些领域涉及以下讨论问题：（i）现有技术的价值是什么？；（ii）当前利用差距是什么？；（iii）可用的工具和资源有哪些？；（iv）变革的杠杆是什么？；（v）期望的结果是什么？；以及（vi）基础行为者是谁？
使用这六个问题来构建 HTR 面临的问题，将推进对 HTR 的共同理解，并改善 HTR 举措的实施。这些问题将明确确定在复杂的医疗保健系统中向前推进所需的流程。
