Financial Management of healthcare organizations
HPI4007
Case 4 Shall I do an economic evaluation?
Designs which can be used for an economic evaluation of a medical technology.
Health Technology Assessment (HTA):
Used to facilitate decision-making in implementation. It
answers questions about safety, cost-effectiveness and
efficacy of health technologies. Takes into account all costs
and benefits from multiple perspectives.
(It is recommended to have a social perspective).
It is a multidisciplinary process that summarizes information
about the medical, social, economic, and ethical issues
related to the use of health technology in a systematic,
transparent, unbiased, robust manner”.
Goal of a HTA is to support healthcare decisions and inform policy-making through objective
information. To improve the quality of care by promoting an appropriate and rational use of health
technologies.
The total costs are taken into account, while the managers usually use marginal costs.
Economic evaluation is a branch of HTA, as for instance epidemiological, judicial, ethical, and social
aspects
Economic evaluation looks at the costs and effects of (new) interventions.
There is growing interest in implementing HTA methods at the hospital level because it could
facilitate decision-making regarding acquisition, implementation or discontinuation of technologies
or interventions within the hospital.
HTA can be conducted at the central (national) level, or at other levels of health-care decision-
making in countries characterized by a decentralized system.
4 perspectives in HTA:
1. Technology: information about alternative technologies is required
2. Patient: takes patient costs into account, costs and benefits, about health-related
benefits and satisfaction-related benefits)
3. Organization: taking organization cost relevant into account
4. Economy: taking all costs into account
These perspectives have to be taken into account to know which one is the best alternative in
interventions. These perspectives tend to clash (e.g. something could be beneficial, but not
sustainable).
2 reasons for using HTA:
1. Helps policymaking at some level, because it takes different costs into account.
2. Legitimacy in organizations; organizations have to be able to show that their analysis is very
important and reliable. In terms of communication it is important to show that it is reliable
and not just an idea from the organization.
, Financial Management of healthcare organizations
HPI4007
The main approaches to perform HTA within hospitals
The HTAi Hospital Based Health Technology Assessment Sub-interest Group has proposed a
framework for classifying the various types of HTA activities that exist at the health-care organization
level, depending on institutional and other socio-economic factors characterizing the health care
systems in different countries.
The purpose of this framework is to provide a common understanding, taking into account the
variability among hospital-based HTA approaches.
Key Points for Decision-Makers:
Hospital-based health technology assessment (HTA) is gaining significant interest among
policy-makers because of its potential for improving decisions regarding health technologies.
Four main models of hospital-based HTA have been proposed: the ambassador model, the
mini-HTA, the internal committee and the HTA unit. Nevertheless, hospital-based HTA
entities are often a combination of these models.
Despite increasing hospital-based HTA, very little is known about its impact on decision-
making at the organizational level.
HPI4007
Case 4 Shall I do an economic evaluation?
Designs which can be used for an economic evaluation of a medical technology.
Health Technology Assessment (HTA):
Used to facilitate decision-making in implementation. It
answers questions about safety, cost-effectiveness and
efficacy of health technologies. Takes into account all costs
and benefits from multiple perspectives.
(It is recommended to have a social perspective).
It is a multidisciplinary process that summarizes information
about the medical, social, economic, and ethical issues
related to the use of health technology in a systematic,
transparent, unbiased, robust manner”.
Goal of a HTA is to support healthcare decisions and inform policy-making through objective
information. To improve the quality of care by promoting an appropriate and rational use of health
technologies.
The total costs are taken into account, while the managers usually use marginal costs.
Economic evaluation is a branch of HTA, as for instance epidemiological, judicial, ethical, and social
aspects
Economic evaluation looks at the costs and effects of (new) interventions.
There is growing interest in implementing HTA methods at the hospital level because it could
facilitate decision-making regarding acquisition, implementation or discontinuation of technologies
or interventions within the hospital.
HTA can be conducted at the central (national) level, or at other levels of health-care decision-
making in countries characterized by a decentralized system.
4 perspectives in HTA:
1. Technology: information about alternative technologies is required
2. Patient: takes patient costs into account, costs and benefits, about health-related
benefits and satisfaction-related benefits)
3. Organization: taking organization cost relevant into account
4. Economy: taking all costs into account
These perspectives have to be taken into account to know which one is the best alternative in
interventions. These perspectives tend to clash (e.g. something could be beneficial, but not
sustainable).
2 reasons for using HTA:
1. Helps policymaking at some level, because it takes different costs into account.
2. Legitimacy in organizations; organizations have to be able to show that their analysis is very
important and reliable. In terms of communication it is important to show that it is reliable
and not just an idea from the organization.
, Financial Management of healthcare organizations
HPI4007
The main approaches to perform HTA within hospitals
The HTAi Hospital Based Health Technology Assessment Sub-interest Group has proposed a
framework for classifying the various types of HTA activities that exist at the health-care organization
level, depending on institutional and other socio-economic factors characterizing the health care
systems in different countries.
The purpose of this framework is to provide a common understanding, taking into account the
variability among hospital-based HTA approaches.
Key Points for Decision-Makers:
Hospital-based health technology assessment (HTA) is gaining significant interest among
policy-makers because of its potential for improving decisions regarding health technologies.
Four main models of hospital-based HTA have been proposed: the ambassador model, the
mini-HTA, the internal committee and the HTA unit. Nevertheless, hospital-based HTA
entities are often a combination of these models.
Despite increasing hospital-based HTA, very little is known about its impact on decision-
making at the organizational level.
