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波兰医院为基础的卫生技术评估的实施与发展:医院代表的观点:定性研究。

Implementation and development of hospital-based health technology assessment in Poland from the perspective of hospital representatives: qualitative research.

机构信息

Institute of Public Health, Health Policy and Management Department, Health Sciences Faculty, Jagiellonian University Medical College, Cracow, Poland.

Institute of Healthcare Management, Łazarski University, Warsaw, Poland.

出版信息

Front Public Health. 2024 Oct 8;12:1426420. doi: 10.3389/fpubh.2024.1426420. eCollection 2024.

Abstract

INTRODUCTION

The analysis of health technologies in Poland has so far mainly concerned drugs assessed by the Agency for Health Technology Assessment and Tariffication, which was established for this purpose. Due to the implementation of various forms of investment (hardware, diagnostic, and organizational) in hospitals, and the growing need to properly assess the costs of implemented solutions, Hospital-Based Health Technology Assessment (HB-HTA) began to develop. In order to implement HB-HTA in the Polish healthcare system, in 2019-2022 a project was carried out, the consortium members of which were: the National Health Fund (NHF), the National Institute of Cardiology in Warsaw (NIKARD), and Lazarski University (UŁ).

PURPOSE OF THE STUDY

Analyzing the possibilities of developing HB-HTA in Polish hospitals based on the experiences of the study participants. Presenting benefits and barriers for HB-HTA units implementation to Polish hospitals.

METHODS

Qualitative analysis of in-depth interviews with the representatives of hospitals that participated in the HB-HTA project using the Nvivo12 program. A specially prepared questionnaire with questions regarding the pre-project, design, and post-project phases was presented to respondents from five of the seven hospitals participating in the pilot phase of the project, during which HB-HTA reports were prepared for selected medical technologies. The remaining two facilities that were invited refused to participate in the study. The Ethics Committee of the Jagiellonian University Medical College gave consent to conduct the study.

RESULTS

Hospital representatives indicate that the HB-HTA methodology allows for the assessment of investments in facilities based on appropriate data. Thanks to the project, employees of hospital units gained new skills, such as becoming familiar with literature reviews in medical bibliographic databases. However, HB-HTA in Poland has not been fully implemented because facilities do not obtain adequate benefits from the implementation of HB-HTA at the organizational and financial level. According to the study participants, the methodology itself should be modified to take into account the needs of the facility.

CONCLUSION

The hospitals participating in the HB-HTA project are developing the field of analyzing how innovative solutions are implemented in their facilities, but not to the extent that was intended in the project design.

摘要

简介

迄今为止,波兰对卫生技术的分析主要涉及为评估目的而设立的卫生技术评估和定价机构所评估的药物。由于医院实施了各种形式的投资(硬件、诊断和组织),以及越来越需要正确评估实施解决方案的成本,基于医院的卫生技术评估(HB-HTA)开始发展。为了在波兰医疗保健系统中实施 HB-HTA,2019-2022 年开展了一个项目,其财团成员包括:国家卫生基金(NHF)、华沙国家心脏病学研究所(NIKARD)和拉扎尔大学(UŁ)。

研究目的

基于研究参与者的经验,分析波兰医院发展 HB-HTA 的可能性。介绍 HB-HTA 单位在波兰医院实施的收益和障碍。

方法

对参与 HB-HTA 项目的医院代表进行深入访谈的定性分析,使用 Nvivo12 程序。向该项目试点阶段的五家医院的受访者提供了一份专门编制的问卷,其中包含有关项目前、项目设计和项目后阶段的问题。该项目邀请的另外两家医院拒绝参与研究。雅盖隆大学医学院伦理委员会同意进行这项研究。

结果

医院代表表示,HB-HTA 方法允许根据适当的数据评估设施投资。由于该项目,医院单位的员工获得了新的技能,例如熟悉医学文献数据库中的文献综述。然而,由于设施在组织和财务层面上没有从 HB-HTA 的实施中获得足够的收益,因此波兰尚未全面实施 HB-HTA。根据研究参与者的说法,该方法本身应进行修改,以考虑到设施的需求。

结论

参与 HB-HTA 项目的医院正在发展分析创新解决方案在其设施中实施情况的领域,但没有达到项目设计的预期程度。

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