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Evaluating Opportunities to Implement Hospital-Based Health Technology Assessment (HB-HTA) in Selected Hospitals in the Kraków Municipality

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Dusza D., Furman M., Gałązka-Sobotka M., Kowalska-Bobko I.
Zarządzanie Publiczne / Public Governance
|
2021
|
issue 1(55)
35-49
EN
Objectives: Hospitals are the entry point for newly implemented innovative health technologies. Hospital-based health technology assessment (HB-HTA) has been developed to facilitate the use of new health technologies in hospitals. The purpose of this study was to evaluate opportunities to implement HB-HTA in selected hospitals located in the Kraków municipality in Poland. Research Design & Method: We used shortened version of a questionnaire from a project called “Implementation of the Hospital-Based HTA (HB-HTA) – Hospital Assessment of Innovative Medical Technologies”. The participants were hospital managers working in three hospitals located in Kraków: the Ujastek Medical Centre Limited Liability Company (LLC), the Brothers Hospitallers of Saint John of God Hospital LLC, and the University Hospital in Kraków. The survey was conducted and made available online. Findings: Each of the participating hospitals had implemented new medical technologies. Applications for the implementation of innovative medical technology had been considered by the hospital directors; however, departmental heads were required to act as the lead applicants. Two out of these three hospitals had developed both an application template for the implementation of innovative technologies and a formalized path for their examination. The main source of financing new technologies is the hospitals’ funds. Before implementing the technology, hospitals had consulted the following agencies: the National Health Fund, the Ministry of Health, medical technology manufacturers or producer organisations, medical voivodeship consultants, and other hospitals. The financial consequences of the medical technologies implementation were analyzed. Implications / Recommendations: The hospitals define innovative medical technologies in a correct way. There are no separate HTA units in any of the hospitals. The surveyed hospitals have the capability to implement HB-HTA. Contribution / Value Added: The implementation of HB-HTA processes in the analysed hospitals may require the hospital managers to broaden knowledge about this area. The implementation of HB-HTA procedures in hospitals may have positive economic effects on the entire health care system.
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IDENTYFIKACJA SIŁ WSPIERAJĄCYCH I HAMUJĄCYCH PROCES IMPLEMENTACJI HB-HTA W POLSCE

88%
Gałązka-Sobotka M., Frączkiewicz-Wronka A., Kowalska-Bobko I., Kelm H., Szymaniec-Mlicka K.
Polityka Społeczna
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2020
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vol. 47
|
issue 8(557)
18-27
EN
Increasing health care costs and deteriorating situation of hospitals enforce the need to search for improved methods of management. One of the proposals is to base the process of making investment decisions in hospitals on HB-HTA, i.e. hospital-based health technologies assessment, which is reflected in the implementation of the project entitled Implementation of the Hospital Based HTA (HB HTA) – Hospital Assessment of Innovative Medical Technologies. Introducing such a significant change for the functioning of hospitals and the entire healthcare system requires careful planning of its implementation. One of the stages of introducing the change is the analysis of its conditions. The purpose of this article is to present the results of research conducted as the first stage of the Gospostrateg project on the determinants of the implementation of hospital-based health technology assessment procedures (HB-HTA) into the Polish healthcare system. The research used exploratory research strategy typical for grounded theory, using the Lewin’s force field analysis methodology to collect data. Studies have indicated the existence of 28 macro environmental factors actively affecting the process of implementing HB-HTA in the functioning of hospitals. The analysis of Lewin’s force field allowed the identification of 5 restraining forces and 5 forces driving the HB-HTA implementation process with a visible advantage of the driving forces. The proposed strategy for implementing the change should focus on weakening the restraining forces, including the main force which is the shortage of financial resources, and strengthening the competences of the management in the area of HB-HTA methodology.
PL
Rosnące koszty ochrony zdrowia w skali systemu oraz pogarszająca się sytuacja szpitali wymuszają poszukiwanie nowych metod usprawniania zarządzania. Jedną z propozycji jest oparcie procesu podejmowania decyzji inwestycyjnych w szpitalach na HB-HTA, czyli szpitalnej ocenie technologii medycznych, czego wyrazem jest realizacja projektu pt. „Wdrożenie systemu Hospital-Based HTA (HB-HTA) – Szpitalnej Oceny Innowacyjnych Technologii Medycznych”. Wprowadzenie tak istotnej dla funkcjonowania szpitali i całego systemu zmiany wymaga starannego planowania. Jednym z etapów tej zmiany jest analiza jej uwarunkowań. Celem artykułu jest zaprezentowanie rezultatów i dyskusji nad wynikami prowadzonymi w pierwszym etapie realizacji projektu Gospostrateg (Projekt nr 1/395107/18/NCBR/2018 „Wdrożenie systemu Hospital-Based HTA (HB-HTA) – Szpitalnej Oceny Innowacyjnych Technologii Medycznych”, realizowany przez konsorcjum Narodowego Funduszu Zdrowia, Instytutu Kardiologii Stefana kardynała Wyszyńskiego – Państwowy Instytut Badawczy oraz Uczelnię Łazarskiego w Warszawie) badań nad uwarunkowaniami wdrożenia do polskiego systemu ochrony zdrowia procedur oceny technologii medycznych na poziomie szpitalnym (ang. Hospital – Based Health Technology Assessment, HB-HTA). W prowadzonych badaniach zastosowano eksploracyjną strategię badawczą typową dla teorii ugruntowanej, wykorzystując do gromadzenia danych metodykę analizy pola sił Lewina. Badania wskazały 28 czynników w makrootoczeniu aktywnie oddziałujących na proces wdrożenia HB-HTA w praktykę działania szpitali. Analiza pola sił Lewina pozwoliła na identyfikację 5 sił hamujących i 5 sił wspierających proces wdrożenia HB-HTA przy widocznej punktowej przewadze sił wspierających proces zmian. Proponowana strategia działania przy wprowadzaniu zmiany powinna skupić się na osłabieniu sił hamujących, w tym głównej siły, jaką jest niedobór środków finansowych oraz wzmacnianiu kompetencji kadry zarządzającej w obszarze stosowania metodyki HB-HTA w zarządzaniu szpitalami.
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