Authors' objectives:

The objective of health technology assessment (HTA) is to support decision-making in the health sector by assessing health technologies systematically under medical, economic, social, and ethical aspects. The present study aims at identifying ways of enabling the impact of HTA on decision-making processes in the German health sector. The authors formulate three research questions: (1) Can methods be identified that allow a valid assessment of the impact of HTA reports on the decision-making processes? (2) Has been shown an impact of HTA reports on decision-making processes in the health sector? (3) Which are the factors responsible for a high or a low impact of HTA?

Authors' recommendations: There is little experience with study designs or methods that allow a valid assessment of the impact of HTA reports on the decision-making process in the health sector. However, some approaches, such as the use of pre-defined indicators, were identified that should be pursued and elaborated in further studies. Due to the lack of a developed methodology only limited conclusions related to the impact of HTA reports can be drawn. Among the studies that show a relevant impact, most are methodological. However, results from qualitative studies caution against assuming a causal relationship where a mere coincidence between the recommendations of an HTA report and health policy is identified. In order to produce evidence-based conclusions regarding the impact of HTA reports, validated indicators should be used. Study design should also aim at controlling for other influencing factors. None of the studies explicitly aim at examining the role of the factors that might be responsible for a low or high impact of the HTA reports. The nonsystematic retrospective analyses do not allowr eliable conclusions regarding the relevance of these factors. Therefore the factors identified here should only serve for hypothesis formation. On the basis of these studies it is not possible to give evidence-based recommendations on the way how to increase the impact of HTA on decision-making in Germany. Instead a concept for evaluation should be developed that combines quantitative and qualitative methods and considers the following questions: (1) What kind of impact should be measured? (2) Which are the target groups and at which level of the health system are they located? (3) Which are the outcome parameters and how can they be measured? (4) Which are the potential impact enhancing or limiting factors?

Authors' methods: Systematic review

Project Status: Completed

URL for project: http://www.dimdi.de/

Year Published: 2006

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Germany

Organisation Name: German Agency for HTA at the German Institute for Medical Documentation and Information

Contact Address: German Agency for Health Technology Assessment at the German Institute for Medical Documentation and Information, Waisenhausgasse 36-38a, D-50676 Cologne Germany

Contact Name: dahta@dimdi.de

Contact Email: dahta@dimdi.de

Copyright: German Agency of Health Technology Assessment at German Institute for Medical Documentation and Information (DAHTA) (DIMDI)