Attitudes and barriers toward mini-HTA in the Danish municipalities

In 2008 the Danish National Board of Health launched an information campaign aimed at introducing mini-HTA as a management and decision support tool for the municipalities. Today (January 2012), mini-HTA is still not used regularly in the municipalities.

The aim of this study was to evaluate the latent attitudes toward mini-HTA among ninety-three participants in five voluntary workshops on mini-HTA held in the period of May 2008 to February 2009.

In a questionnaire including three open questions respondents were asked to state their perception of what mini-HTA could be used for in the municipality, the main barriers for using mini-HTA, and what could make it easier to implement mini-HTA. Answers were analyzed qualitatively and quantitatively using binary coding and statistical examination of patterns in form of R-factor analysis.

The four significant latent attitudes were a general acceptance of HTA-principles, a derived need for a political/managerial decision to use mini-HTA in the municipality, worries about barriers in the medium run, and worries about barriers in the short run.

A national information campaign to support the uptake of mini-HTA in local health-care institutions was insufficient in the Danish municipalities and should have been supplemented with a strategy to secure local political/managerial willingness to use mini-HTA and the removal of short- and medium-term barriers. The implementation of local HTA should not just be seen as a question of how to increase the use of evidence in decision-making, but as a matter of reforming local decision processes.