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IMPACT OF HEALTH TECHNOLOGY ASSESSMENT REPORTS ON HOSPITAL DECISION MAKERS – 10-YEAR INSIGHT FROM A HOSPITAL UNIT IN SHERBROOKE, CANADA: IMPACT OF HEALTH TECHNOLOGY ASSESSMENT ON HOSPITAL DECISIONS

Published online by Cambridge University Press:  19 July 2018

Thomas G. Poder Open the ORCID record for Thomas G. Poder [Opens in a new window] ,
Christian A. Bellemare ,
Suzanne K. Bédard ,
Jean-François Fisette  and
Pierre Dagenais Open the ORCID record for Pierre Dagenais [Opens in a new window]
Thomas G. Poder
Affiliation:
UETMIS, CIUSSS de l'Estrie - CHUS, Sherbrooke, Department of Family Medicine and Emergency Medicine, Faculty of Medicine and Health Sciences, University of Sherbrooke, Centre de recherche du Centre hospitalier universitaire de Sherbrooke (CRCHUS), Department of Economics, École de Gestion, University of [email protected]
Christian A. Bellemare
Affiliation:
UETMIS, CIUSSS de l'Estrie - CHUS, Sherbrooke
Suzanne K. Bédard
Affiliation:
UETMIS, CIUSSS de l'Estrie - CHUS, Sherbrooke
Jean-François Fisette
Affiliation:
UETMIS, CIUSSS de l'Estrie - CHUS, Sherbrooke
Pierre Dagenais
Affiliation:
UETMIS, CIUSSS de l'Estrie - CHUS, Sherbrooke, Centre de recherche du Centre hospitalier universitaire de Sherbrooke (CRCHUS), Department of Medicine, Faculty of Medicine and Health Sciences, University of Sherbrooke
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Abstract

Objectives:

The overarching goal of this research was to (i) evaluate the impact of reports with recommendations provided by a hospital-based health technology assessment (HB-HTA) unit on the local hospital decision-making processes and implementation activities and (ii) identify the underlying factors of the nonimplementation of recommendations.

Methods:

All reports produced by the HB-HTA unit between December 2003 and March 2013 were retrieved, and hospital decision makers who requested these reports were solicited for enrolment. Participants were interviewed using a mixed design survey.

Results:

Twenty reports, associated with fifteen decision makers, fulfilled the study criteria. Nine decision makers accepted to participate, corresponding to thirteen reports and twenty-three recommendations. Of the twenty-three recommendations issued, 65 percent were implemented, 9 percent were accepted for implementation but not implemented, and 26 percent were declined. In terms of the utility of each report to guide decision makers, 92 percent of the reports were considered in the decision-making process; 85 percent had one or more recommendations adopted; and 77 percent had recommendations implemented. The most frequently mentioned reasons for nonimplementation were related to contextual factors (64 percent), production/diffusion process factors (14 percent), content/format factors (14 percent), or other factors (9 percent). Among the contextual factors, the complexity of the changes (i.e., administrative reasons), budget and resources constraints, failure to identify administrative responsibility to carry out the recommendation, and nonpriority status of the HTA recommendation, were provided.

Conclusions:

This study highlights that although HB-HTA reports are useful to hospital managers in their decision-making processes, certain barriers such as contextual factors need to be better addressed to improve HB-HTA efficiency and usefulness.

Keywords

Health technology assessmentHospital-based HTAImpact of HTA recommendationsPerceptions of decision makers
Type
Assessment
Information
International Journal of Technology Assessment in Health Care , Volume 34 , Issue 4 , 2018 , pp. 393 - 399
Copyright
Copyright © Cambridge University Press 2018 

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Footnotes

The authors acknowledge the contributions of all participants who diligently accepted to take part of this study. The authors thank Martin Coulombe and Renald Lemieux for their valuable suggestions on the validation of our questionnaire. We acknowledge Louise Corbeil, Sylvain Bernier, and Linda Pinsonneault for their assistance and comments. We also thank the Unité de Recherche Clinique et Épidémiologique (URCE) of the Centre de recherche du CHU de Sherbrooke for their support in coordinating the preparation and revisions of this manuscript. Thomas G. Poder is member of the FRQS-funded Centre de recherche du CHUS (CRCHUS). This project was funded by the operating budget of the UETMIS of the CHUS.

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