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Expert Rev Pharmacoecon Outcomes Res. 2018 Apr;18(2):223-232. doi: 10.1080/14737167.2017.1375407. Epub 2017 Sep 8.

Best-worst scaling to assess the most important barriers and facilitators for the use of health technology assessment in Austria.

Author information

1
a Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences , Maastricht University , Maastricht , The Netherlands.
2
d Department of Health Economics , Center for Public Health, Medical University of Vienna , Vienna , Austria.
3
b Department of Health Promotion, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences , Maastricht University , Maastricht , The Netherlands.
4
c Trimbos Institute , Netherlands Institute of Mental Health and Addiction , Utrecht , The Netherlands.
5
e Ludwig Boltzmann Institute Applied Diagnostics , Vienna , Austria.

Abstract

BACKGROUND:

Although Health Technology Assessment (HTA) is increasingly used to support evidence-based decision-making in health care, several barriers and facilitators for the use of HTA have been identified. This best-worst scaling (BWS) study aims to assess the relative importance of selected barriers and facilitators of the uptake of HTA studies in Austria.

METHODS:

A BWS object case survey was conducted among 37 experts in Austria to assess the relative importance of HTA barriers and facilitators. Hierarchical Bayes estimation was applied, with the best-worst count analysis as sensitivity analysis. Subgroup analyses were also performed on professional role and HTA experience.

RESULTS:

The most important barriers were 'lack of transparency in the decision-making process', 'fragmentation', 'absence of appropriate incentives', 'no explicit framework for decision-making process', and 'insufficient legal support'. The most important facilitators were 'transparency in the decision-making process', 'availability of relevant HTA research for policy makers', 'availability of explicit framework for decision-making process', 'sufficient legal support', and 'appropriate incentives'.

CONCLUSION:

This study suggests that HTA barriers and facilitators related to the context of decision makers, especially 'policy characteristics' and 'organization and resources' are the most important in Austria. A transparent and participatory decision-making process could improve the adoption of HTA evidence.

KEYWORDS:

Health technology assessment; barriers; best-worst scaling; decision-making; facilitators; stakeholders

PMID:
28862060
DOI:
10.1080/14737167.2017.1375407
[Indexed for MEDLINE]

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