scholarly journals Broadening the application of health technology assessment in the Netherlands: a worthwhile destination but not an easy ride?

2020 ◽  
pp. 1-17
Author(s):  
Joost J. Enzing ◽  
Saskia Knies ◽  
Bert Boer ◽  
Werner B.F. Brouwer
Keyword(s):  
Health Care ◽  
Decision Making ◽  
The Netherlands ◽  
Marketing Authorisation ◽  
Health Technology ◽  
Decision Making Process ◽  
Dutch Government ◽  
Policy Makers ◽  
Policy Measures ◽  
Selection Of

Abstract Currently, reimbursement decisions based on health technology assessments (HTA) in the Netherlands mostly concern outpatient pharmaceuticals. The Dutch government aspires to broaden the systematic application of full HTA towards other types of health care in order to optimise the content of the basic benefit package. This paper identifies important challenges for broadening the scope of full HTA to other types of health care. Based on a description of the Dutch reimbursement decision-making process, five important characteristics of outpatient pharmaceuticals were identified, which are all relevant to the successful application of HTA: (i) closed reimbursement system, (ii) absence of alternative policy measures, (iii) existence of marketing authorisation, (iv) identifiable and accountable counterparty, and (v) product characteristics. For a selection of other types of health care, which may be subject to HTA more frequently in the future, deviations from these characteristics of outpatient pharmaceuticals are discussed. The implications of such deviations for performing HTA and the decision-making process are highlighted. It is concluded that broadening the application of HTA will require policy makers to meet both important policy-related and methodological challenges. These challenges differ per health care domain, which may inform policy makers which expansions of the current use of HTA are most feasible.

Different cost-benefit analyses in The Netherlands for the European Water Framework Directive

Water Policy ◽  
2010 ◽  
Vol 12 (5) ◽  
pp. 746-760 ◽  
Author(s):  
R. van der Veeren
Keyword(s):  
Decision Making ◽  
The Netherlands ◽  
Water Framework Directive ◽  
Cost Benefit ◽  
European Water Framework Directive ◽  
Decision Making Process ◽  
Policy Makers ◽  
European Water ◽  
Trade Offs ◽  
Economic Analyses

Since 2005, several cost benefit analyses have been performed for the European Water Framework Directive (WFD) in The Netherlands. These analyses had in common that they were meant to support the decision-making process by informing policy makers and making the trade-offs as transparent as possible. The analyses also anticipate questions from the Dutch Parliament. Nevertheless, each time the analyses were slightly different, depending on the situation and (political) questions that had to be answered. This article presents the background and the highlights of the various analyses, describes their differences and similarities and tries to find a common thread in the results. Even though the results are barely comparable for a number of reasons, they seem to indicate that such a line exists and that economic analyses have played a role in the decision-making process by making tradeoffs more explicit. This has offered the opportunity for an iterative dialogue with the Dutch Parliament, which contributed to a decision-making process which resulted in a socially accepted programme of measures that is economically sound and transparent.

THE IMPACT OF HEALTH TECHNOLOGY ASSESSMENT REPORTS ON DECISION MAKING IN AUSTRIA

2012 ◽  
Vol 28 (1) ◽  
pp. 77-84 ◽  
Author(s):  
Ingrid Zechmeister ◽  
Ines Schumacher
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Health Technology Assessment ◽  
Technology Assessment ◽  
Health Care Expenditure ◽  
Health Technology ◽  
Decision Making Process ◽  
Inclusion Criteria ◽  
Distribution Of Resources ◽  
The Impact

Objectives: Health technology assessment (HTA) was established in Austria in the 1990s and, since then, it has gained considerable importance. In this study, we aim to analyze whether the HTA reports that have been produced at the Institute for Technology Assessment (ITA) and at the Ludwig Boltzmann Institute for HTA (LBI-HTA) have had an impact on decision making within the Austrian health care system.Methods: We selected all reports that were intended for supporting (i) reimbursement/investment or (ii) disinvestment decisions. Eleven full HTA reports and fifty-eight rapid assessments fulfilled the inclusion criteria. We used interview data and administrative data on volumes, tariffs and expenditure of products/services to analyze whether and how reports were in reality used in decision making and what the consequences for health care expenditure and resource distribution have been.Results: Five full HTA reports and fifty-six rapid technology assessments were used for reimbursement decisions. Four full HTA reports and two rapid assessments were used for disinvestment decisions and resulted in reduced volumes and expenditure. Two full HTA reports showed no impact on decision making. Impact was most evident for hospital technologies.Conclusions: HTA has played some role in reducing volumes of over-supplied hospital technologies, resulting in reduced expenditure for several hospital providers. Additionally, it has been increasingly included in prospective planning and reimbursement decisions of late, indicating re-distribution of resources toward evidence-based technologies. However, further factors may have influenced the decisions, and the impact could be considerably increased by systematically incorporating HTA into the decision-making process in Austria.

scholarly journals Health technology assessment in sub-Saharan Africa: a descriptive analysis and narrative synthesis

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Samantha Hollingworth ◽  
Ama Pokuaa Fenny ◽  
Su-Yeon Yu ◽  
Francis Ruiz ◽  
Kalipso Chalkidou
Keyword(s):  
Decision Making ◽  
Health Technology Assessment ◽  
Technology Assessment ◽  
Technical Assistance ◽  
Health Technology ◽  
Sub Saharan Africa ◽  
Main Theme ◽  
Narrative Synthesis ◽  
Policy Makers ◽  
Sub Saharan

Abstract Background Countries in Sub-Saharan Africa (SSA) are moving towards universal health coverage. The process of Health Technology Assessment (HTA) can support decisions relating to benefit package design and service coverage. HTA involves institutional cooperation with agreed methods and procedural standards. We systematically reviewed the literature on policies and capacity building to support HTA institutionalisation in SSA. Methods We systematically reviewed the literature by searching major databases (PubMed, Embase, etc.) until June 2019 using terms considering three aspects: HTA; health policy, decision making; and SSA. We quantitatively extracted and descriptively analysed content and conducted a narrative synthesis eliciting themes from the selected literature, which varied in study type and apporach. Results Half of the 49 papers identified were primary research studies and mostly qualitative. Five countries were represented in six of ten studies; South Africa, Ghana, Uganda, Cameroon, and Ethiopia. Half of first authors were from SSA. Most informants were policy makers. Five themes emerged: (1) use of HTA; (2) decision-making in HTA; (3) values and criteria for setting priority areas in HTA; (4) involving stakeholders in HTA; and (5) specific examples of progress in HTA in SSA. The first one was the main theme where there was little use of evidence and research in making policy. The awareness of HTA and economic evaluation was low, with inadequate expertise and a lack of local data and tools. Conclusions Despite growing interest in HTA in SSA countries, awareness remains low and HTA-related activities are uncoordinated and often disconnected from policy. Further training and skills development are needed, firmly linked to a strategy focusing on strengthening within-country partnerships, particularly among researchers and policy makers. The international community has an important role here by supporting policy- relevant technical assistance, highlighting that sustainable financing demands evidence-based processes for effective resource allocation, and catalysing knowledge-sharing opportunities among countries facing similar challenges.

Who determines the final version? The roles of translators, language revisers and editors in the publishing of a literary translation

2021 ◽  
Vol 22 (1) ◽  
pp. 14-44
Author(s):  
Marija Zlatnar Moe ◽  
Tamara Mikolič Južnič ◽  
Tanja Žigon
Keyword(s):  
Decision Making ◽  
Conflict Resolution ◽  
Literary Translation ◽  
Central Position ◽  
Decision Making Process ◽  
Translation Process ◽  
Revision Process ◽  
Final Version ◽  
Comparison Of The Results ◽  
Selection Of

AbstractThe article explores the interaction among three key figures in the process of publication of a literary translation into a language of low diffusion: the translator, the editor and the language reviser (the latter specific to the Slovene situation). The aim of the research is to identify who has the strongest position of power in the decision-making process of the production of a literary translation, especially when conflict arises. Information was gathered from the three groups with questionnaires, interviews and an analysis of public statements. The questions focused on the selection of the translator and language reviser, the translation process, the revision process and conflict resolution. A cross-comparison of the results indicates that despite the automatic central position of the editors, they tend to yield their decision-making power to translators, while language revisers have a more subservient, consulting role.

scholarly journals The Psychological Puzzle: Contributing Factors to the Top-Down Politicization of Intelligence

Elements ◽  
2016 ◽  
Vol 12 (1) ◽  
Author(s):  
Rebecca Moretti
Keyword(s):  
Decision Making ◽  
Intelligence Community ◽  
Decision Making Process ◽  
Symbiotic Relationship ◽  
Rational Decision ◽  
Contributing Factors ◽  
Political Leaders ◽  
Top Down ◽  
Policy Makers ◽  
Rational Decision Making

Policy and intelligence are intimately intertwined. Policymakers need intelligence to make decisions, while the intelligence community derives significance from its ability to provide policy makers with reliable information. In this symbiotic relationship, it is healthy for intelligence consumers to at times check and direct the work of intelligence producers. However, if undertaken maliciously, this checking mechanism manifests as top-down politicization. Here, leaders use intelligence post facto to legitimize their policies instead of using it to guide them, reversing the rational decision-making process. Certain factors may compel leaders to manipulate intelligence to reflect their policy preferences. This essay demonstrates how three distinct processes of top-down politicization can arise from ambiguous evidence, the psychology of intelligence consumers, and the nature of the leaders’ political positions and responsibilities. It then proceeds to argue that political leaders’ psychology is the most potent source of top-down politicization.

HEALTH TECHNOLOGY ASSESSMENT AND CLINICAL DECISION MAKING:

1999 ◽  
Vol 15 (3) ◽  
pp. 585-592 ◽  
Author(s):  
Alicia Granados
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Health Technology Assessment ◽  
Case Studies ◽  
Technology Assessment ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Health Technology ◽  
Evidence Based ◽  
Systematic Process

This paper examines the rationality of the concepts underlying evidence—based medicineand health technology assessment (HTA), which are part of a new current aimed at promoting the use of the results of scientific studies for decision making in health care. It describes the different approaches and purposes of this worldwide movement, in relation to clinical decision making, through a summarized set of specific HTA case studies from Catalonia, Spain. The examples illustrate how the systematic process of HTA can help in several types of uncertainties related to clinical decision making.

scholarly journals Understanding the perspectives of older adults and elderly regarding vaccination; a snapshot in four European countries

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
A Timen ◽  
R Eilers ◽  
S Lockhart ◽  
R Gavioli ◽  
S Paul ◽  
...  
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Decision Making ◽  
Infectious Diseases ◽  
Health Care Professionals ◽  
Elderly Care ◽  
European Countries ◽  
Decision Making Process ◽  
Ageing Population ◽  
Syncytial Virus

Abstract Prevention of infectious diseases in elderly by immunization is a prerequisite to ensuring healthy ageing. However, in order for the vaccine programs to be effective, these need to be provided by health care professionals who have up-to-date knowledge and high motivation. Furthermore, the knowledge and attitudes towards vaccination in the targeted age groups needs to be fully understood. When focusing on the information provision, it is important to know from whom or which institution older adults and elderly would like to receive and in which form. In January 2019, an international project called the VITAL (The Vaccines and InfecTious diseases in the Ageing population) project was started, within the framework of IMI (Innovative Medicines Initiatives). One of the goals of the VITAL project is to develop strategies to educate and train health care professionals (HCPs) and to promote awareness among stakeholders involved in elderly care management. We briefly focus on the results of studies undertaken in four European countries (Italy, France, The Netherlands and Hungary), which reveal the perspective of older adults and elderly regarding influenza, pneumococcal, herpes zoster vaccination and respiratory syncytial virus (RSV) as well as generic characteristics of the vaccines and diseases. We will show how attitudes towards vaccination are represented in our study population and which determinants influence the decision-making process of accepting vaccination. Furthermore, we shall elaborate on how the decision-making process towards vaccination takes place and which additional information is needed. In the second part of the session, we shall invite the audience to reflect on the findings and identify the factors they consider most important for setting up a training and education programme on vaccination.

scholarly journals Announcing the Canadian Journal of Health Technologies — A New Journal From CADTH

2021 ◽  
Vol 1 (1) ◽  
Author(s):  
Nicole Mittmann
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Health System ◽  
Canadian Journal ◽  
Health Technology ◽  
Health Care Decision ◽  
Health Technologies ◽  
Care Decision

The COVID-19 pandemic has put a spotlight on science and reaffirmed the value of evidence in health care decision-making. CADTH is a major Canadian publisher of evidence, advice, and recommendations regarding the assessment and management of health technologies. The Canadian Journal of Health Technologies will publish CADTH work in a single, PubMed-indexed, online location, making it easier for our health system partners to search and find CADTH work. Through the Canadian Journal of Health Technologies, CADTH will expand its reach and its collaborations with producers and users of health technology assessments.

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