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WHICH CRITERIA ARE CONSIDERED IN HEALTHCARE DECISIONS? INSIGHTS FROM AN INTERNATIONAL SURVEY OF POLICY AND CLINICAL DECISION MAKERS

Published online by Cambridge University Press:  02 December 2013

Nataly Tanios ,
Monika Wagner ,
Michèle Tony ,
Rob Baltussen ,
Janine van Til ,
Donna Rindress ,
Paul Kind ,
Mireille M. Goetghebeur  and
the International Task Force on Decision Criteria
Nataly Tanios
Affiliation:
University of Montreal; EVIDEM Collaboration
Monika Wagner
Affiliation:
LA-SER Analytica
Michèle Tony
Affiliation:
University of Montreal; EVIDEM Collaboration
Rob Baltussen
Affiliation:
Radboud University Nijmegen Medical Centre
Janine van Til
Affiliation:
University of Twente
Donna Rindress
Affiliation:
LA-SER Analytica
Paul Kind
Affiliation:
University of York
Mireille M. Goetghebeur
Affiliation:
University of Montreal; LA-SER Analytica
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Abstract

Objectives: The aim of this study was to gather qualitative and quantitative data on criteria considered by healthcare decision makers.

Methods: Using snowball sampling and an online questionnaire with forty-three criteria organized into ten clusters, decision makers were invited by an international task force to report which criteria they consider when making decisions on healthcare interventions in their context. Respondents reported whether each criterion is “currently considered,” “should be considered,” and its relative weight (scale 0–5). Differences in proportions of respondents were explored with inferential statistics across levels of decision (micro, meso, macro), decision maker perspectives, and world regions.

Results: A total of 140 decision makers (1/3 clinical, 2/3 policy) from 23 countries in five continents completed the survey. The most relevant criteria (top ranked for “Currently considered,” “Should be considered,” and weights) were Clinical efficacy/effectiveness, Safety, Quality of evidence, Disease severity, and Impact on healthcare costs. Organizational and skill requirements were frequently considered but had relatively low weights. For almost all criteria, a higher proportion of decision makers reported that they “Should be considered” than that they are “Currently considered” (p < .05). For more than 74 percent of criteria, there were no statistical differences in proportions across levels of decision, perspectives and world regions. Statistically significant differences across several comparisons were found for: Population priorities, Stakeholder pressure/interests, Capacity to stimulate research, Impact on partnership and collaboration, and Environmental impact.

Conclusions: Results suggest convergence among decision makers on the relevance of a core set of criteria and on the need to consider a wider range of criteria. Areas of divergence appear to be principally related to contextual factors.

Keywords

CriteriaDecision makingPriority settingMulticriteriaHealth care
Type
Policies
Information
International Journal of Technology Assessment in Health Care , Volume 29 , Issue 4 , October 2013 , pp. 456 - 465
Copyright
Copyright © Cambridge University Press 2013 

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