Lipska Iga, Di Bidino Rossella, Niewada Maciej, Nemeth Bertalan, Bochenek Tomasz, Kukla Monika, Więckowska Barbara, Sobczak Alicja, Iłowiecka Katarzyna, Zemplenyi Antal, Martelli Nicolas, Martin Tess, Filiniuk Olena, Kosyachenko Kostyantyn, Sucu Rabia, Piniazhko Oresta, Zaliska Olha, Avdeyev Andrey, Shanazarov Nasrulla, von Pinoci Marina, Hren Rok
Health Policy Institute, 00-819 Warsaw, Poland.
Medical Department, Academy of Applied Medical and Social Sciences, 82-300 Elbląg, Poland.
Healthcare (Basel). 2024 Apr 25;12(9):889. doi: 10.3390/healthcare12090889.
The purpose of this article is to investigate the common facilitators and barriers associated with the implementation of hospital-based health technology assessment (HB-HTA) across diverse hospital settings in seven countries. Through a two-round Delphi study, insights were gathered from a panel of 15 HTA specialists from France, Hungary, Italy, Kazakhstan, Poland, Switzerland, and Ukraine. Experts initially conducted a comprehensive review of the HB-HTA implementation in their respective countries, identifying the barriers and facilitators through descriptive analysis. Subsequently, panel experts ranked these identified barriers and facilitators on a seven-point Likert scale. A median agreement score ≥ 6 and interquartile range (IQR) ≤ 1 was accepted as reaching a consensus. Out of the 12 statements categorized as external and internal barriers and facilitators, the expert panel reached consensus on six statements (two barriers and four facilitators). The external barrier, which achieved consensus, was the lack of the formal recognition of the role of HB-HTA in national or regional legislations. The internal barrier reaching consensus was the limited availability of human resources dedicated to HB-HTA. This qualitative study indicates that HB-HTA still has progress to make before being formally accepted and integrated across most countries, although by building on the facilitating factors we identified there may be an opportunity for the implementation of internationally developed strategies to strengthen HB-HTA practices.
本文旨在调查在七个国家不同医院环境中实施基于医院的卫生技术评估（HB-HTA）的常见促进因素和障碍。通过两轮德尔菲研究，从来自法国、匈牙利、意大利、哈萨克斯坦、波兰、瑞士和乌克兰的15名卫生技术评估专家小组中收集了意见。专家们首先对各自国家的HB-HTA实施情况进行了全面审查，通过描述性分析确定了障碍和促进因素。随后，专家小组对这些确定的障碍和促进因素按照七点李克特量表进行排名。中位数一致得分≥6且四分位间距（IQR）≤1被视为达成共识。在归类为外部和内部障碍及促进因素的12条陈述中，专家小组对6条陈述（2条障碍和4条促进因素）达成了共识。达成共识的外部障碍是HB-HTA在国家或地区立法中的作用缺乏正式认可。达成共识的内部障碍是专门用于HB-HTA的人力资源有限。这项定性研究表明，在大多数国家正式接受并整合HB-HTA之前，它仍有进步空间，不过基于我们确定的促进因素，或许有机会实施国际制定的战略来加强HB-HTA实践。
