International Journal of Technology Assessment in Health Care

Table of Contents - 2006 - Volume 22, Issue 03  


GENERAL ESSAYS

Doing mini–health technology assessments in hospitals: A new concept of decision support in health care?

Lars Ehlers a1, Malene Vestergaard a2, Kristian Kidholm a3, Birgitte Bonnevie a2, Poul Holt Pedersen a4, Torben Jørgensen a5, Malene Fabricius Jensen a2, Finn Børlum Kristensen a6 and Mette Kjølby a1
a1 Aarhus University and Aarhus University Hospital
a2 National Board of Health
a3 Odense University Hospital
a4 Bispebjerg Hospital
a5 HTA Consultant
a6 University of Southern Denmark and National Board of Health

Abstract

Objectives: The purpose of this project was to evaluate local decision support tools used in the Danish hospital sector from a theoretical and an empirical point of view.

Methods: The use of local decision support was evaluated through questionnaires sent to all county health directors, all hospital managers, and all heads of clinical departments in cardiology, orthopedic surgery, and intensive care. In addition, respondents were asked to submit whatever decision support tools they were using (including mini-HTAs, other forms or checklists, and special procedures for decision making concerning new health technologies). A theoretical analysis of the decision support tools (decision theory) was performed as well as a comparison with the business case method used in private companies. Finally, the Danish mini-HTA was compared with foreign production and use of HTA and HTA-like assessments as local decision support.

Results: The response rate was high (87 percent, 94 percent, 85 percent, respectively). We collected sixty different forms (of which forty-nine were mini-HTAs) and twenty variants of written procedures. We found theoretical and empirical evidence that local involvement in the process of making the HTA could be important for the use of the results from the HTA and for the process of implementing the new technology.

Conclusions: Doing mini-HTA in hospitals seems to balance the need for quality and depth with the limited time and resources for assessment.


Key Words: HTA; Health technology assessment; Mini-HTA; Decision support; Management tool; Decision support tool; HTA form.