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Resource allocation and health technology assessment in Australia: Views from the local level

Published online by Cambridge University Press:  31 March 2009

Gisselle Gallego
Affiliation:
University of Technology, Sydney
Kees van Gool
Affiliation:
University of Technology, Sydney
Dianne Kelleher
Affiliation:
Northern Sydney Central Coast Area Health Service

Abstract

Objectives: Several studies have shown that a key determinant of successful health technology assessment (HTA) uptake is a clear, fair, and consistent decision-making process for the approval and introduction of health technologies. The aim of this study was to gauge healthcare providers' and managers' perceptions of local level decision making and determine whether these processes offer a conducive environment for HTA. An Area Health Service (AHS) aimed to use the results of this study to help design a new process of technology assessment and decision making.

Methods: An online survey was sent to all health service managers and healthcare providers working in one AHS in Sydney, Australia. Questions related to perceptions of current health technology decisions in participants' own institution/facility and opinions on key criteria for successful decision-making processes.

Results: Less than a third of participants agreed with the statements that local decision-making processes were appropriate, easy to understand, evidence-based, fair, or consistently applied. Decisions were reportedly largely influenced by total cost considerations as well as by the central state health departments and the Area executive.

Conclusions: Although there are renewed initiatives in HTA in Australia, there is a risk that such investments will not be productive unless policy makers also examine the decision-making contexts within which HTA can successfully be implemented. The results of this survey show that this is especially true at the local level and that any HTA initiative should be accompanied by efforts to improve decision-making processes.

Type
General Essays
Copyright
Copyright © Cambridge University Press 2009

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References

REFERENCES

1. Australian Government Productivity Commission. Impacts of advances in medical technology in Australia: Productivity Commission research report. Melbourne: Productivity Commission; 2005.Google Scholar
2. Borowski, HZ, Brehaut, J, Hailey, D. Linking evidence from health technology assessments to policy and decision making: The Alberta model. Int J Technol Assess Health Care. 2007;23:155161.CrossRefGoogle ScholarPubMed
3. Buxton, MJ. Economic evaluation and decision making in the UK. Pharmacoeconomics. 2006;24:11331142.CrossRefGoogle ScholarPubMed
4. Department of Surgery of the Calgary Health Region. Local health technology assessment program. http://www.calgaryhealthregion.ca/surgery/officesurgical-research/HTA.htm. Accessed May 7, 2007.Google Scholar
5. Gallego, G, Fowler, S, van Gool, K. Decision makers' perceptions of health technology decision making and priority setting at the institutional level. Aust Health Rev. 2008;32:520527.CrossRefGoogle ScholarPubMed
6. Gallego, G, Melocco, T, Taylor, SJ, Brien, JE. Access to high-cost drugs: Decision makers' perspectives. J Pharm Pract Res. 2005;35:1820.CrossRefGoogle Scholar
7. Griffith, G. Commonwealth-state responsibilities for health: “Big bang” or incremental reform? Briefing paper no. 17/06. Sydney: Parliament of NSW; 2006.Google Scholar
8. Hailey, DM, Roseman, C. Health care technology in Australia and New Zealand: Contrasts and cooperation. Health Policy. 1990;14:177189.CrossRefGoogle ScholarPubMed
9. Hoffmann, C, Graf von der Schulenburg, JM. The influence of economic evaluation studies on decision making. A European survey. The EUROMET group. Health Policy. 2000;52:179192.CrossRefGoogle ScholarPubMed
10. IJzerman, MJ, Reuzel, RP, Severens, HL. Pre-assessment to assess the match between cost-effectiveness results and decision makers' information needs: An illustration using two cases in rehabilitation medicine in the Netherlands. Int J Technol Assess Health Care. 2003;19:1727.CrossRefGoogle ScholarPubMed
11. Jansson, S, Anell, A. The impact of decentralised drug-budgets in Sweden – a survey of physicians' attitudes towards costs and cost-effectiveness. Health Policy. 2006;76:299311.CrossRefGoogle ScholarPubMed
12. Lehoux, P, Denis, JL, Tailliez, S, Hivon, M. Dissemination of health technology assessments: Identifying the visions guiding an evolving policy innovation in Canada. J Health Polit Policy Law. 2005;30:603641.CrossRefGoogle ScholarPubMed
13. Martin, D, Singer, P. A strategy to improve priority setting in health care institutions. Health Care Anal. 2003;11:5968.CrossRefGoogle ScholarPubMed
14. McGregor, M, Brophy, JM. End-user involvement in health technology assessment (HTA) development: A way to increase impact. Int J Technol Assess Health Care. 2005;21:263267.CrossRefGoogle ScholarPubMed
15. Mitchell, AS. Antipodean assessment. Activities, actions, and achievements. Int J Technol Assess Health Care. 2002;18:203212.CrossRefGoogle ScholarPubMed
16. New South Wales Health Department. Model policy for the safe introduction of new interventional procedures into clinical practice: A model policy for area health services and other public health organisations. http://www.health.nsw.gov.au/archive/cib/circulars/2003/cir2003-84.pdf. Accessed November 2, 2006.Google Scholar
17. Northern Sydney Central Coast (NSCCH) Health. Annual report 2005–2006. http://www.nsccahs.health.nsw.gov.au/publications/NSCCH-2005-06-AR.pdf. Accessed May 3, 2007.Google Scholar
18. Organisation for Economic Co-operation and Development. Health technologies and decision making. Paris: OECD; 2005.Google Scholar
19. Southern Health. The new clinical procedures committee, new procedures, new technologies & beyond. http://www.southernhealth.org.au/cpme/bulletin/bull_12_01/article3.htm. Accessed June 11, 2007.Google Scholar
20. Spigelman, AD. Governance and innovation: Experience with a policy on the introduction of new interventional procedures. ANZ J Surg. 2006;76:913.CrossRefGoogle ScholarPubMed
21. Strauss, AL, Corbin, J. Basics of qualitative research: Techniques and procedures for developing grounded theory. 2nd ed. Thousand Oaks, CA: Sage Publications; 1998.Google Scholar
22. The Society of Hospital Pharmacists of Australia (SHPA). Moving forward – the funding of medicines in Australia's hospitals. Melbourne: The Society of Hospital Pharmacists of Australia (SHPA); 2004.Google Scholar
23. van Velden, ME, Severens, JL, Novak, A. Economic evaluations of healthcare programmes and decision making: The influence of economic evaluations on different healthcare decision making levels. Pharmacoeconomics. 2005;23:10751082.CrossRefGoogle ScholarPubMed
24. Victorian Department of Human Services. Victorian policy advisory committee on clinical practice and technology (VPACT). http://www.health.vic.gov.au/newtech/committee.htm. Accessed June 11, 2007.Google Scholar
25. Zwart-van Rijkom, JE, Leufkens, HG, Busschbach, JJ et al. , Differences in attitudes, knowledge and use of economic evaluations in decision making in the Netherlands. The Dutch results from the EUROMET project. Pharmacoeconomics. 2000;18:149160.CrossRefGoogle ScholarPubMed
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