为十亿人口做预算：在印度实现全民健康覆盖应用卫生技术评估（HTA）。
Budgeting for a billion: applying health technology assessment (HTA) for universal health coverage in India.
机构信息
Health Intervention and Technology Assessment Program (HITAP), Nonthaburi, Thailand.
Global Health and Development Group, Imperial College London, London, United Kingdom.
出版信息
Health Res Policy Syst. 2018 Nov 29;16(1):115. doi: 10.1186/s12961-018-0378-x.
BACKGROUND
India recently launched the largest universal health coverage scheme in the world to address the gaps in providing healthcare to its population. Health technology assessment (HTA) has been recognised as a tool for setting priorities as the government seeks to increase public health expenditure. This study aims to understand the current situation for healthcare decision-making in India and deliberate on the opportunities for introducing HTA in the country.
METHODS
A paper-based questionnaire, adapted from a survey developed by the International Decision Support Initiative (iDSI), was administered on the second day of the Topic Selection Workshop that was conducted as part of the HTA Awareness Raising Workshop held in New Delhi on 25-27 July, 2016. Participants were invited to respond to questions covering the need, demand and supply for HTA in their context as well as the role of their organisation vis-à-vis HTA. The response rate for the survey was about 68% with 41 participants having completed the survey.
RESULTS
Three quarters of the respondents (71%) stated that the government allocated healthcare resources on the basis of expert opinion. Most respondents indicated reimbursement of individual health technologies and designing a basic health benefit package (93% each) were important health policy areas while medical devices and screening programmes were cited as important technologies (98% and 92%, respectively). More than half of the respondents noted that relevant local data was either not available or was limited. Finally, technical capacity was seen as a strength and a constraint facing organisations.
CONCLUSION
The findings from this study shed light on the current situation, the opportunities, including potential topics, and challenges in conducting HTA in India. There are limitations to the study and further studies may need to be conducted to inform the role that HTA will play in the design or implementation of universal health coverage in India.
背景
印度最近推出了全球最大的全民医疗保险计划，以解决为其民众提供医疗保健方面的差距。人们已经认识到，卫生技术评估（HTA）是政府寻求增加公共卫生支出时确定优先事项的一种手段。本研究旨在了解印度医疗保健决策的现状，并讨论在该国引入 HTA 的机会。
方法
在 2016 年 7 月 25 日至 27 日在新德里举行的 HTA 提高认识研讨会上，作为专题选择研讨会的一部分，对与会者进行了基于国际决策支持倡议（iDSI）制定的问卷调查。与会者被邀请回答涵盖其背景下 HTA 的需求、需求和供应以及其组织在 HTA 方面的作用的问题。调查的回复率约为 68%，有 41 名参与者完成了调查。
结果
四分之三的受访者（71%）表示，政府根据专家意见分配医疗资源。大多数受访者表示，个别卫生技术的报销和设计基本的健康福利包（各占 93%）是重要的卫生政策领域，而医疗器械和筛查计划则被认为是重要的技术（各占 98%和 92%）。超过一半的受访者指出，相关的本地数据要么不可用，要么有限。最后，技术能力被视为组织的优势和制约因素。
结论
本研究的结果阐明了印度进行 HTA 的现状、机会（包括潜在的主题）和挑战。该研究存在局限性，可能需要进一步研究，以告知 HTA 在印度设计或实施全民医疗保险中的作用。
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