TOWARD A CONTINGENCY MODEL FOR HOSPITAL-BASED HEALTH TECHNOLOGY ASSESSMENT: EVIDENCE FROM ADHOPHTA PROJECT

Area of Science:

• Health Services Research
• Health Technology Assessment
• Organizational Studies

Background:

• Hospital-based health technology assessment (HB-HTA) is crucial for managing medical technologies.
• Organizational structures for HB-HTA vary based on context.
• Existing dominant models share commonalities.

Purpose of the Study:

• To explore, describe, interpret, and explain seven HB-HTA applications.
• To propose a classification of HB-HTA organizational models.
• To provide insights for policymakers and HTA professionals.

Main Methods:

• Case study methodology applied to seven HB-HTA initiatives across seven countries.
• Qualitative and quantitative data collection.
• Cross-case analysis using contingent organizational theory.

Main Results:

• Organizational variables like formalization and integration with other HTA bodies shape HB-HTA approaches.
• A contingency model of HB-HTA was identified.
• Four emergent organizational models: integrated specialized HTA unit, stand-alone HTA unit, integrated-essential HTA, and independent group unit.

Conclusions:

• No single best approach exists for hospital-level HTA.
• HB-HTA model characteristics are context-dependent.
• This conceptualization can improve HB-HTA adoption for better decision-making and clinical practice.