Shamir Medical Center (Assaf Harofeh), 70300, Zerifin, Israel.
ICET - Israeli Center for Emerging Technologies, Zerifin, Israel.
Health Res Policy Syst. 2019 Jul 23;17(1):72. doi: 10.1186/s12961-019-0469-3.
Technology adoption in hospitals is usually based on cost-effectiveness analysis, feasibility and potential success. Different countries have embraced a range of principles to accomplish an effective comprehensive process of health technology assessment (HTA). The aim of the study was to analyse the viewpoints and relative weight of technology-oriented hospital staff members toward the clinical, social, technological and economic aspects of HTA.
Using a structured questionnaire, a survey was conducted among different professionals in an 850-bed hospital.
We revealed a range of viewpoints among hospital staff members according to their personal characteristics and professional standpoints. The clinical aspects of HTA were considered 'highly important' (HI) by most participants, especially the 'lifesaving' parameter. Similarly, the 'lack of effective alternative technology' was ranked HI by a high percentage of participants, independent of their profession. Economic aspects were ranked HI only by half of the participants, while social and technological aspects were ranked HI only by a relatively low percentage. Nurses added 'improving quality of life', 'increasing teamwork efficiency' and 'improving medical standards'. Allied health professionals focused on 'lack of effective alternative technologies' as a main argument for adoption of HTA, alongside increasing efficiency, budget savings and contribution to hospital reputation. Engineers emphasised the requirement of significant investment in infrastructure and increasing efficiency. Administrators ranked patient experience as HI. Interestingly, the high ranking of social aspects correlated with older responders, while junior staff ranked safety significantly higher.
A multi-perspective multidisciplinary approach would be beneficial for policy-makers at hospitals and even on a national scale in Israel.
医院采用技术通常基于成本效益分析、可行性和潜在成功。不同国家采用了一系列原则来完成有效的卫生技术评估(HTA)综合过程。本研究旨在分析医院技术导向型员工对 HTA 的临床、社会、技术和经济方面的观点和相对权重。
使用结构化问卷,对一家 850 张床位医院的不同专业人员进行了调查。
根据个人特征和专业立场,我们揭示了医院员工之间的一系列观点。HTA 的临床方面被大多数参与者认为是“高度重要”(HI),尤其是“救命”参数。同样,“缺乏有效替代技术”被很大比例的参与者列为 HI,无论其专业如何。只有一半的参与者将经济方面列为 HI,而社会和技术方面仅被相对较低的比例列为 HI。护士增加了“提高生活质量”、“提高团队工作效率”和“提高医疗标准”。辅助医疗专业人员将“缺乏有效替代技术”作为采用 HTA 的主要论据之一,同时还提高了效率、节省了预算并有助于医院的声誉。工程师强调基础设施重大投资和提高效率的要求。管理人员将患者体验列为 HI。有趣的是,社会方面的高排名与年长的应答者相关,而年轻员工则将安全性列为更高。
多视角多学科方法将有利于医院的决策者,甚至在以色列的国家层面上也是如此。