Hostname: page-component-78c5997874-v9fdk Total loading time: 0 Render date: 2024-11-14T03:28:41.291Z Has data issue: false hasContentIssue false

HOSPITAL-BASED HEALTH TECHNOLOGY ASSESSMENT IN BRAZIL: AN OVERVIEW OF THE INITIAL EXPERIENCES

Published online by Cambridge University Press:  23 June 2017

Claudia Cristina de Aguiar Pereira
Affiliation:
Escola Nacional de Saúde Pública, [email protected]
Renata dos Santos Rabello
Affiliation:
INI, Fiocruz
Flávia Tavares Silva Elias
Affiliation:
Fiocruz, Brasília

Abstract

Objectives: Hospital-based health technology assessment (HTA) has become increasingly important in Brazil due to its strategic importance to promote adoption, incorporation, dissemination, and disinvestment of technologies. A strategy to foster hospital-based HTA was implemented in 2009 by creating hospital-based HTA nuclei (NATS) at university hospitals and other strategic hospitals.

Methods: Between 2011 and 2012, we interviewed board members in twenty-three NATS located in all geographic regions of Brazil to assess their general characteristics, scientific output, and challenges.

Results: Of the total, 65 percent of the NATS belonged to teaching institutions, with 44 percent associated with federal universities. The bulk of their output was in the form of mini-HTA reports. Centers in the Southeast and South of Brazil had the highest production compared with other regions. Lack of expertise and low levels of advanced training were identified as limiting factors in the majority of centers.

Conclusions: The experience of the initial twenty-three NATS could be considered positive and has led to the creation of new ones around Brazil. Regional disparities in workload, production, and technical training should be targeted by new policies toward hospital-based HTA in Brazil. The limits and possibilities for intensifying the strategy relate to continuous investment in priority studies, which simultaneously, allow professionals who work in hospitals to receive continued education and produce relevant HTA work in a timely manner.

Type
Assessments
Copyright
Copyright © Cambridge University Press 2017 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

1. Garrido, A, Marcial, V, Kristensen, FB, et al. Health technology assessment and health policy making in Europe. Current status, challenges and potential. Copenhagen: World Health Organization; 2008. Observatory Study Series n° 14.Google Scholar
2. Banta, H. The development of health technology assessment. Health Policy. 2003;63:121-132.Google Scholar
3. Panerai, BR, Mohr, PJ. Evaluacion de Tecnologias en Salud: metodologías para países en desarrollo. Washington: Organizacion Panamericana de la Salud; 1990.Google Scholar
4. Kahveci, R, Tutuncu, T, Esra Koc, M, et al. Early results of AdHopHTA and potential contribution to development of HTA in Turkey. Health Technology Assessment International 2014 - 11th Annual Meeting. Abstract Volume. http://www.pthv.de/fileadmin/user_upload/PDF_Pflege/Vorlesungsunterlagen/Bruehl/HTAI_AbstractVolume_web1_S.147.pdf (accessed July 2015).Google Scholar
5. Krauss-Silva, L. Avaliação tecnológica em saúde: questões metodológicas e operacionais. Cadernos de Saúde Pública. 2004;20 (Supp 2):199-207.Google Scholar
6. Brasil. Ministério da Saúde. Secretaria de Ciência, Tecnologia e Insumos Estratégicos. Departamento de Ciência e Tecnologia. Política Nacional de Gestão de Tecnologias em Saúde. Secretaria de Ciência, Tecnologia e Insumos Estratégicos, Departamento de Ciência e Tecnologia. Brasília: Ministério da Saúde; 2010.Google Scholar
7. Departamento de Ciência e Tecnologia, Secretaria de Ciência e Tecnologia e Insumos estratégicos, Ministério da Saúde, Brasil. Avaliação de Tecnologias em saúde: institucionalização das ações do Ministério da Saúde. Rev Saúde Pública. 2006;40:743-747.Google Scholar
8. Brasil, Ministério da Saúde. Secretaria de Ciência, Tecnologia e Insumos Estratégicos. Departamento de Ciência e Tecnologia. REBRATS. [Website]. http://rebrats.saude.gov.br/institucional/nats (accessed June 2016).Google Scholar
9. Elias, FTS, Leao, LSC, Assis, EC. Avaliação de tecnologias em hospitais de ensino: desafios atuais. Tempus: Actas de Saúde Coletiva. 2015;9:147-158.CrossRefGoogle Scholar
10. Decimoni, T, Leandro, R, Soarez, P, et al. Systematic review of economic evaluation of health technologies developed in Brazil from 1980–2013. ISPOR 17th Annual European Congress. Abstract Volume http://www.ispor.org/ScientificPresentationsDatabase/Presentation/53273 (accessed July 2015).Google Scholar
11. Novaes, H, Elias, F. Uso da avaliação de tecnologias em saúde em processos de análise para incorporação de tecnologias no Sistema Único de Saúde no Ministério da Saúde. Cad Saúde Pública. 2013;29: s7-s16.Google Scholar
12. Ormstand, S, Graff, B, Norderhang, I. Survey and discussion of existing mini-HTA systems internationally. Oslo: Norwegian Knowledge Centre for The Health Service; 2010.Google Scholar
13. Vestergaard, M, Ehlers, L, Kidholm, K, et al. Introduction to mini-HTA: a management and decision support tool for the hospital service. København: Danish Centre for Evaluation and Health Technology Assessment; 2005. http://www.sst.dk/publ/Publ2005/CEMTV/Mini_MTV/Introduction_mini_HTA.pdf (accessed July 2015).Google Scholar
14. Hospital based health technology assessment sub-interest group. Hospital Based Health Technology Assessment World-Wide Survey. http://www.htai.org/fileadmin/HTAi_Files/ISG/HospitalBasedHTA/2008Files/HospitalBasedHTAISGSurveyReport.pdf (accessed June 2016).Google Scholar
15. Furno, C, Leogrande, L, Cicchetti, A, et al. The impact of hospital based reports on medical devices of Unità Di Valutazione Delle Tecnologie (UVT). Health Technology Assessment International 2014 - 11th Annual Meeting. Abstract Volume. HTAi website. http://www.pthv.de/fileadmin/user_upload/PDF_Pflege/Vorlesungsunterlagen/Bruehl/HTAI_AbstractVolume_web1_S.147.pdf (accessed July 2015).Google Scholar
16. Martelli, N, Lelong, A, Prognon, P, et al. Hospital-based health technology assessment for innovative medical devices in university hospitals and the role of hospital pharmacists: Learning from international experience. Int J Technol Assess Health Care. 2013;29:185-191.Google Scholar
17. Mitchell, M, Williams, K, Brennan, P, et al. Integrating local data into hospital-based healthcare technology assessment: Two case studies. Int J Technol Assess Health Care. 2010;26:294-300.Google Scholar
18. Arentz-Hansen, H, Frønsdal, K, Pasternack, I, et al. Characterization of the interaction between hospital-based HTA programs and HTA activities at national and regional levels in AdHopHTA-partner countries. Health Technology Assessment International 2014 - 11th Annual Meeting. Abstract Volume. HTAi website. http://www.pthv.de/fileadmin/user_upload/PDF_Pflege/Vorlesungsunterlagen/Bruehl/HTAI_AbstractVolume_web1_S.147.pdf (accessed July 2015).Google Scholar
19. Martelli, N, Billaux, M, Borget, I, et al. Introduction of innovative medical devices at French University Hospitals: An overview of hospital-based health technology assessment initiatives. Int J Technol Assess Health Care. 2015;31:12-18.Google Scholar
20. Favaretti, C, Cicchetti, A, Guarrera, G, Marchetti, M, Ricciardi, W. Health technology assessment in Italy. Int J Technol Assess Health Care. 2009;25:127-133.Google Scholar
21. Attieh, R, Gagnon, M. Implementation of local/hospital-based health technology assessment initiatives in low- and middle-income countries. Int J Technol Assess Health Care. 2012;28:445-451.Google Scholar
22. Demirdjian, G. A 10-year hospital-based health technology assessment program in a public hospital in Argentina. Int J Technol Assess Health Care. 2015;31:103-110.Google Scholar
23. Gagnon, M, Desmartis, M, Poder, T, et al. Effects and repercussions of local/hospital-based health technology assessment (HTA): a systematic review. Syst Rev. 2014;3:129.CrossRefGoogle ScholarPubMed
24. Parés, D, Sampietro-Colom, L, Haro, J, et al. Health technology assessment (HTA) in a community hospital: Lessons from the learning curve. Health Technology Assessment International 2014 - 11th Annual Meeting. Abstract Volume. HTAi website. http://www.pthv.de/fileadmin/user_upload/PDF_Pflege/Vorlesungsunterlagen/Bruehl/HTAI_AbstractVolume_web1_S.147.pdf (accessed July 2015).Google Scholar
25. Danglas, L, Rosenmöller, M, Ribeiro, M, et al. A systematic approach to define a framework for best practices in hospital based health technology assessment. Health Technology Assessment International 2014 - 11th Annual Meeting. Abstract Volume. HTAi website. http://www.pthv.de/fileadmin/user_upload/PDF_Pflege/Vorlesungsunterlagen/Bruehl/HTAI_AbstractVolume_web1_S.147.pdf (accessed July 2015).Google Scholar
26. Brasil, Ministério da Saúde. Secretaria de Ciência, Tecnologia e Insumos Estratégicos. Departamento de Ciência e Tecnologia. Rede Brasileira de Avaliação de Tecnologias em Saúde website. http://rebrats.saude.gov.br/membros (accessed July 2016).Google Scholar
Supplementary material: File

Pereira supplementary material

Pereira supplementary material 1

Download Pereira supplementary material(File)
File 108 KB