Hostname: page-component-cd9895bd7-8ctnn Total loading time: 0 Render date: 2024-12-25T04:30:48.801Z Has data issue: false hasContentIssue false
  • English
  • Français

Technology assessment, priority setting, and appropriate care in Dutch health care

Published online by Cambridge University Press:  23 April 2004

Marc Berg ,
Tom van der Grinten  and
Niek Klazinga
Marc Berg
Affiliation:
Erasmus University, Rotterdam
Tom van der Grinten
Affiliation:
Erasmus University, Rotterdam
Niek Klazinga
Affiliation:
University of Amsterdam
Get access Rights & Permissions [Opens in a new window]

Abstract

This article provides a critical analysis of the impact of health technology assessment (HTA) on priority setting in The Netherlands. It describes the limited steering powers of the Dutch government; its complex interactions with insurers, health-care providers, and patients; and the role of HTA in this context as an attempt to rationalize the debate about cost-effectiveness issues. HTA has been drawn upon for decision making on the health insurance package. Also, HTA findings have been linked to the national guideline development programs of the medical community. However, these impacts by no means have been straightforward. We argue that the political nature of the priority-setting debate asks for a broader approach to what constitutes HTA, and how it should be drawn upon in priority setting. Suggestions are made on how to do justice to the social dynamics of decision making and the behavior of stakeholders in health-care systems.

Keywords

Health technology assessmentThe Netherlands
Type
Research Article
Information
International Journal of Technology Assessment in Health Care , Volume 20 , Issue 1 , January 2004 , pp. 35 - 43
Copyright
© 2004 Cambridge University Press

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

AGREE Collaboration. 2000 The AGREE Collaborative Guideline development in Europe. An international comparison. Int J Technol Assess Health Care. 16: 1039– 1049.
AGREE Collaboration. 2002 Development and validation of an international appraisal instrument for assessing the quality of clinical practice guidelines: The AGREE project. Quality Safety Health Care. In press.
Ashmore M, Mulkay M, Pinch T. 1989 Health and efficiency: A sociology of health economics. Milton Keynes: Open University Press;
Bates DW, Pappius E, Kuperman GJ, et al. 1999 Using information systems to measure and improve quality. Int J Med Informatics. 53: 115– 124.Google Scholar
Berg M, ter Meulen RHJ, van den Burg M. 2001 Guidelines for appropriate care: The importance of empirical normative analysis. Health Care Analysis. 9: 77– 99.Google Scholar
Berwick DM. 1998 The NHS's 50 anniversary. Looking forward. The NHS: Feeling well and thriving at 75. BMJ. 317: 57– 61.Google Scholar
Boer A. 1999 Assessment and regulation of health care technology. The Dutch experience. Int J Technol Assess Health Care. 15: 638– 648.Google Scholar
Burger, & al e. xxtitle from Niek. 2002
Committee on Choices in Health Care. 1992 Choices in health care. Rijswijk: Ministry of Welfare, Health, and Cultural Affairs;
Coulter A, Ham C, eds. 2000 The global challenge of health care rationing. Buckingham, Philadelphia: Open University Press;
Elsinga E, Rutten FFH. 1997 Economic evaluation in support of national health policy: The case of The Netherlands. Soc Sci Med. 45: 605– 620.Google Scholar
Grimshaw J, Freemantle N, Wallace S, et al. 1995 Developing and implementing clinical practice guidelines. Qual Health Care. 4: 55– 64.Google Scholar
Grol R. 1997 Beliefs and evidence in changing clinical practice. BMJ. 315: 418– 421.Google Scholar
Grol R, Grimshaw J. 1999 Evidence-based implementation of evidence-based medicine. Jt Comm J Qual Improv. 25: 503– 513.Google Scholar
Health Council of The Netherlands. 1991 Medisch handelen op een tweesprong (Medical treatment at the crossroads) [in Dutch]. The Hague: Health Council of The Netherlands;
Health Council of The Netherlands. 2000 From implementation to learning: The importance of a two-way dialogue between practice and science in health care [in Dutch]. The Hague: Health Council of The Netherlands;
Holm S. 1998 Goodbye to the simple solutions: The second phase of priority setting in health care. BMJ. 317: 1000– 1002.Google Scholar
Hunter DJ. 1997 Desparately seeking solutions. Rationing health care. Harlow: Addison Wesley Longman Ltd;
Keynote address. 1998 Second international conference on priorities in health care; London.
Klazinga NS. 1994 Compliance with practice guidelines: Clinical autonomy revisited. Health Policy. 28: 51– 66.Google Scholar
Klazinga NS. 2000 Sociale geneeskunde: de derde weg. Oratie Universiteit van Amsterdam. Amsterdam: Vossiuspers AUP;
Klein R. 1998 Puzzling out priorities. Why we must acknowledge that rationing is a political process. BMJ. 317: 959– 960.Google Scholar
Latour B. 1997 Socrates' and Callicles' settlement—or, the invention of the impossible body politic. Configurations. 5: 189– 240.Google Scholar
Mulder JH. 1997 Terug naar de zorg. Dunning gekanteld. Medisch Contact. 39: 1219– 1220.Google Scholar
Mulder JH. 2000 Healthcare rationing in The Netherlands: The need for specific guidelines. Med J Aust. 172: 329– 331.Google Scholar
Neeling. 1999 Eindrapport Passende Medische Zorg. Utrecht: KNMG;
Oortwijn WJ. 2000 First things first. Priority setting for health technology assessment. Amsterdam: Free University;
Porter TM. 1995 Trust in numbers. The pursuit of objectivity in science and public life. Princeton: Princeton University Press;
Rutten F. 2000 heb ik niet xx.
Stolk EA, Busschbach JJV, Caffa M, Meuleman EJH, Rutten FFH. 2000 Cost utility analysis of sildenafil compared with papaverine-phentolamine injections. BMJ. 320: 1165.Google Scholar
Van der Grinten TED. 1996 Scope for policy: Essence, operation and reform of the policy of Dutch health care. In: Gunning-Schepers LJ, et al, eds. Fundamental questions about the future of health care. The Hague: Sdu;
Van der Grinten TED. 2002 XX Heb ik niet.
van Hout B, Goes ES, Grijseels EWM, 1999 Quarles van Ufford MA. Economic evaluation in the field of cardiology: Theory and practice. Prog Cardiovasc Dis. 42: 167– 173.Google Scholar
van Rossum W. 1991 Decision-making and medical technology assessment: Three Dutch cases. Knowledge Policy. 4: 107– 124.Google Scholar
Weggeman M. 1997 Kennismanagement: Inrichting en besturing van kennisintensieve organisaties. Schiedam: Scriptum;