Hostname: page-component-7c8c6479df-hgkh8 Total loading time: 0 Render date: 2024-03-19T02:19:03.639Z Has data issue: false hasContentIssue false

Health technology assessment in four countries: response from political science

Published online by Cambridge University Press:  23 April 2004

David Chinitz
Affiliation:
Hebrew University–Hadassah School of Public Health

Abstract

Four studies, each on health technology assessment (HTA) in a different country, are presented in this volume. Conveying differing levels of sensitivity to political aspects of HTA, their storylines are similar in terms of the importance of the institutional structures that produce HTA and mediate its influence on health policy decision making. Regarding the internal politics of HTA, the latter appears to have developed in a relatively depoliticized environment, supported by a dense and varied web of institutional sites for funding, production, and consumption of HTA, buffered from the capricious impacts of electoral politics. Regarding external politics, HTA in all the countries began with relatively politically innocuous studies of technologies recognized to be of major import to national health systems or researcher-initiated studies. However, with increased focus in health systems on explicit determination of health benefits baskets, the role of HTA has become more high profile. This means that political accountability for the entire HTA process will increase. The implication is that future management of HTA programs will require self-conscious attention to the building of institutions capable of handling the delicate process of integrating science and politics in health policy.

Type
Research Article
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

Banta D. 1998 Choices in health care and health care technology assessment. In: Chinitz D, Cohen J, eds. Governments and health systems: Implications of differing involvements. Chichester: John Wiley & Sons; 381387.
Bardach E. 1998 Getting agencies to work together. Washington: Brookings Institute;
Baumgartner FR, Jones BD. 1993 Agendas and instability in American politics. Chicago: University of Chicago Press;
Burke K. 2002 No cash to implement NICE, health authorities tell MPs. BMJ. 324: 258.Google Scholar
Berg M, van der Grinten T, Klazinga N. 2004 Technology assessment, priority setting, and appropriate care in Dutch health care. Int J Technol Assess Health Care. 20: 3543.Google Scholar
Carlsson P. 2004 Health technology assessment and priority setting for health policy in Sweden. Int J Technol Assess Health Care. 20: 4454.Google Scholar
Chinitz D. 1992 A modular approach to competitive reforms in health systems. In: Ellencweig A, ed. Analyzing health systems: A modular approach. Oxford: Oxford University Press; 295316.
Chinitz DP. 1999 The basic basket of health services: Technocracy and politics. Social Security. 54: 5368 (Hebrew).Google Scholar
Chinitz D, Shalev C, Galai N, Israeli A. 1998 Israel's basic basket of health services: The importance of being explicitly implicit. BMJ. 317: 10051007.Google Scholar
Klein R, Williams A. 2000 Setting priorities: What is holding us back- inadequate information or inadequate institutions? In: Coulter A, Ham C, eds. The global challenge of health care rationing. Buckingham: Open University Press; 1526.
Lindblom CE, Cohen DK. 1979 Usable knowledge. New Haven: Yale University Press;
Martin D. 2001 Priority setting decision for new cancer drugs: A qualitative case study. Lancet. 358: 16761681.Google Scholar
Mulrow CD, Lohr KN. 2001 Proof and policy form medical research evidence. J Health Polit Policy Law. 26: 249266.Google Scholar
Nelson R. 1977 The moon and the ghetto. New York: WW Norton & Co;
Orvain J, Xerri B, Matillon Y. 2004 Overview of health technology assessment in France. Int J Technol Assess Health Care. 20: 2534.Google Scholar
Ostrom E. 1999 Institutional rational choice. In: Sabatier PA, ed. Theories of the policy process. Boulder: Westview Press; 3571.
Perry S. 1998 Health technology assessment and quality management experience in the United States. In: Chinitz D, Cohen J, eds. Governments and health systems: Implications of differing involvements. Chichester: John Wiley & Sons; 395406.
Saltman RB. 1998 Convergence, social embeddedness, and the future of health systems in the Nordic region. In: Chinitz D, Cohen J, eds. Governments and health systems: Implications of differing involvements. Chichester: John Wiley & Sons; 6974.
Shani S, Siebzehner MI, Luxenburg O, Shemer J. 2000 Setting priorities for the adoption of health technologies on a national level- the Israeli experience. Health Policy. 54: 169185.Google Scholar
Stevens A, Milne R. 2004 Health technology assessment in England and Wales. Int J Technol Assess Health Care. 20: 1124.Google Scholar
Weiss C. 1980 Social science research and decision making. New York: Columbia University Press;
Williamson OE. 1993 The mechanisms of governance. New York: Oxford University Press;