Health insurance system has been proved to be an effective way to promote the quality of health service in many countries. However, how to control health expenditure under health insurance system remains a problem to be resolved. Some developed countries like UK, Canada and Sweden linked their health technology assessment results with decision making and health insurance management, and made prominent achievements in both expenditure control and quality improvement. China is carrying out its health system reform and running a new health insurance project. Using the experiences of other countries is undoubtedly of great importance in developing and managing our health insurance system.
Hospital-based health technology assessment (HB-HTA) refers to the practice of health technology assessment for hospital management decision-making based on the actual situations in hospitals. It includes processes and methods of health technology assessment carried out in and for hospitals. Under the background of comprehensively promoting the reform of public hospitals in China, HB-HTA is undoubtedly an important scientific method to enhance the fine management of public hospitals and implement the policy of medical reform. This paper introduced the concept, the international and domestic development status, the characteristics of HB-HTA, and put forward the scheme of development of HB-HTA macroscopically, so as to promote the popularization and applications of HB-HTA in China.
As a methodological tool, evidence-based management can assess the technological advantages and economical value of medical consumables scientifically, and select the most cost-effective products into the hospital access directory with guarantees of the development of clinical disciplines. Now this method has been widely used for consumable access management in our hospital. Policies and processes have been established to normalize the assess, allocation, and usage, and the management mode is transformed from experience-based management into evidence-based management. With clinical nominalism being changed, the method of evidence-based management can be used for every link of comsumble management, to reduce the costs and ensure the safety and quality of medical consumables at the same time, so as to promote the rational cost of medical consumables.
ObjectiveTo utilize a rapid health technology assessment to evaluate the efficacy, safety and cost-effectiveness of the MitraClip device for patients with severe mitral regurgitation (MR). MethodsPubMed, EMbase, The Cochrane Library, CNKI, WanFang Data, CBM and the CRD databases were electronically searched to collect clinical evidence and economic evaluations on the efficacy, safety and cost-effectiveness of the MitraClip device for patients with severe MR from inception to May 2022. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies; then, descriptive analyses and data summaries were performed. ResultsA total of 33 studies, involving 4 HTA reports, 3 RCTs, 16 systematic reviews or meta-analyses, and 10 economic evaluations were included. In the evidence comparing MitraClip and surgery, most of the literature showed that the MitraClip group had higher postoperative residual MR, fewer blood transfusion events, and fewer hospital days. We found no significant treatment effects on 30-day adverse events and mortality, and the 1-year and above survival rate. In the evidence of MitraClip versus medical therapy alone, all included studies showed that MitraClip benefited mid-term and long-term survival and reduced the incidence of subsequent cardiac hospitalizations. Economic evaluations showed that the clinical benefits were cost-effective in the setting of their health service systems. ConclusionThe available high-grade clinical evidence shows that MitraClip is effective and safe to some extent, and has cost-effectiveness compared with traditional treatment in other countries. However, the real-world effectiveness and cost-effectiveness of the MitraClip need to be tested in the Chinese population and health-care setting.
Health Technology Assessment International (HTAi), in conjunction with the International Society for Pharmacoeconomics and Outcomes Research (ISPOR), initiated a joint Task Force and published guideline and a checklist for deliberative processes for health technology assessment (HTA). Currently, there is a lack of guidance for designing and implementing deliberative processes of HTA in China, so this paper performs a detailed interpretation of the guideline and checklist, with a view to providing a reference for China's HTA and deliberative process, in order to promote the dissemination and application of the HTA methodology, and advance the construction of domestic HTA deliberative processes capacity and institutional mechanism.
ObjectiveTo comprehensively review the status quo, contents, and problems of health technology assessments (HTAs) on cardiovascular and cerebrovascular diseases in Chinese rural. MethodsThe CNKI, VIP, WanFang Data and CBM databases were searched for the HTAs on cardiovascular and cerebrovascular diseases in Chinese rural up to October 31st, 2013. Two reviewers independently screened literatures and extracted data, and then the qualitative method was used to systematically analyze the literatures' information and results. ResultsA total of 34 studies were included. Of which, 23 were descriptive studies and 11 were experimental studies. The studied populations were patients and ordinary residents who had received the service of cardiovascular and cerebrovascular diseases health technology in rural, as well as the grassroots medical technical personnel and promotion staffs who had developed the health technologies. HTAs on cardiovascular and cerebrovascular diseases in rural mainly included western medicine health technologies and traditional Chinese medicine (TCM) health technologies. The contents of HTA of the included literatures mainly included:effectiveness, acceptability, requirements, economic characteristics, safety and technical specific property. The results of the included literatures showed that the type of diseases involved in cardiovascular and cerebrovascular diseases in rural were not widely enough, the fields involved in assessment contents were single, lack of rigorous and comprehensive study design. ConclusionWe need more HTAs of cardiovascular and cerebrovascular diseases in rural, we also need to strengthen early prevention, promote a wider range of cardiovascular and cerebrovascular diseases health technology, strengthen promotion and application of both TCM health technologies and the combination of TCM and western medicine health technologies in cardiovascular and cerebrovascular diseases.
ObjectiveTo analyze the research status and hot spots of health technology assessment (HTA). MethodsDatabases including China National Knowledge Infrastructure (CNKI) and PubMed were searched to collect published studies on HTA. The software of BICOMS-2 and VOSviewer 1.6.10 was used to draw the network diagram and to conduct cluster analysis of keywords. ResultsA total of 1170 studies in Chinese and 8584 studies in English were included. The number of HTA-related publications increased annually, among which countries with the most publications were the United States, the United Kingdom, and Canada. Fudan University had the largest number of studies published in Chinese and York University had the largest number of studies published in English. The research topics mainly focused on hospital HTA, HTA decision transformation research, pharmacoeconomic evaluation, etc. The most frequent diseases were cancer and depression. Emerging keywords were real-word evidence, randomized controlled trials, cost-benefit analysis, etc. ConclusionHTA-related studies increase annually. Many HTA-related studies are performed in developed countries, such as the United States and the United Kingdom. The relevant research topics involve hospital HTA, HTA decision-making transformation research, and pharmacoeconomic evaluation. Current research focus is on the evaluation of health economics in the field of cancer based on the evidence of real-world research and randomized controlled trials.
Objective To comprehensively summarize and analyze the status quo, assessing contents and problems of the assessment studies on appropriate health technology in China. Methods With the search terms and strategies predefined by repeated discussion and pre-retrieval, all literature on appropriate health technology assessment in China published from October 1949 to March 2012 were searched in the following databases: CBM, VIP, CNKI and WanFang Data. According to the inclusion and exclusion criteria, two reviewers independently screened literature, and extracted and cross-checked data. Disagreements were resolved by discussion or by involving a third researcher. The qualitative synthesis method was used to analyze the studies. Results Among total 174 included studies, 117 were cross-sectional. Targeted populations were patients and community residents who had received the service or treatment of appropriate health technology, as well as the grassroots medical staffs and workers from marketing organization who had used or carried out the appropriate health technologies. Appropriate health technologies mainly contained four fields of appropriate health technology: traditional Chinese medicine, western medicine, family planning services and community health services. Most types of diseases involved in those technologies were circulatory system diseases, and high blood pressure was highly concerned. The contents of appropriate health technology assessment mainly included 6 aspects: effectiveness, acceptability, economic characteristics, requirements, safety and technical specific property. The results of the included studies indicated that, most assessments focused on just one aspect, and were lack of comprehensive evaluation. The indexes used in each assessment covered a far too wide range, and was lack of unified index and standards. Conclusion Current studies show that the fields of appropriate health technology assessment distribute widely; the assessment content is simple and lack of comprehensive evaluation; the assessment index system has no unified standard; and the study design methods are different and lack of high quality study design. So it is necessary to conduct high quality assessment studies, establish scientific assessment index system, and systematically assess appropriate health technology, so as to provide more scientific basis for health decision makers.
The reporting checklist of health technology assessment (HTA) was a tool developed by the International Network of Agencies for Health Technology Assessment (INAHTA) to be used to guide the reporting of HTA. Experiential evidence showed that the tool was effective to improve the reporting quality of HTA and also could be used as a reference in performing HTA and translating the research evidence into decision-making. This paper introduced the background, developing process and main contents of the checklist, so as to improve the reporting quality of HTA in China.
Health technology assessment (HTA) is becoming more and more popular recently. For populations in China that share at least half of the global disease burden of liver cancer, it is extremely vital to give rise to an efficient secondary prevention strategy. The China central government launched liver cancer screening program in rural areas in 2005, and then extended to populations in urban in 2012. The studies of health technology assessment of liver cancer screening are based on available evidence, from an HTA perspective, aims to evaluate performance of liver screening, economic burden and cost-effectiveness and some other issues, in order to raise suggestions for possible directions in research and public health program related to liver cancer screening in China.