The Impact of Health Technology Assessment on Decision-Making Processes in Public Versus Not-for-Profit Private Hospitals

Abstract

Problem statement: The goal of this study is to extend research on Evidence-Based Practice (EBP) implementation by examining the decision-making processes for acquiring new health technologies in selected hospitals in Southeast Queensland, Australia. Both a decision-making model and a mini-Health Technology Assessment (HTA) model guide the approach and analysis in this study. We anticipated that both public and private sector organisations would use HTA as the guideline in decision-making processes to acquire new health technologies. Approach: The data were collected using two methods; document analysis and in-depth, face-to-face interviews. The steps in decision-making processes to acquire new health technologies were identified through content and thematic analysis. The HTA process and mini-HTA checklist were used as a bench mark for decision-making processes. Results: Decision making processes were described as informal in not-for-profit private hospitals and as formal in public hospitals. Decisions in not-for-profit private hospitals were driven by business strategy and the cost effectiveness of the technologies. In the public hospital, however, the main factors were safety and clinical effectiveness although budget also has some impact. Decision makers in both types of hospitals were unclear about HTA and its agencies. They also were not aware of mini-HTA, even though they were searching for a suitable support tool for decision making. Conclusion: This study identified the impact of HTA and mini-HTA in public and private hospital settings. Findings from this study show that the evidence from HTA is not fully utilised by decision makers in the hospitals to make informed decisions. Health authorities should play a more active role in educating decision makers at hospital level regarding health technology assessment. Mini-HTA can be a beneficial tool for decision making processes at hospital level.