Designing the Function of Health Technology Assessment as a Support for Hospital Management

Investment in Health Technologies (HTs) is one of the crucial points for hospital managers. It affects the goals and strategic orientation of the whole Health Organization. Decision-making regarding the employment of new technologies involves, prevalently, the hospital level, which directly concerns the healthcare delivery process and its design. Hospital-Based Health Technology Assessment (HB-HTA) is aimed at selecting the portfolio of new HTs that provides the best balance between competing targets, namely, cost containment and quality improvement. This objective is achievable by thinking about how to improve the service delivered, through the use of innovative cost-effective HT. Accordingly, the HTA role deals with the operational modalities of hospital departments, and it is strictly related to outcomes desired and in respect to budgets. This evaluative process should be coherent with specific health organization necessities given that each one is concerned with its own geographic area, its own specific patients’ epidemiology, the social environment, and financial resources’ availability. However, HTA is usually run by practitioners whose competences contemplate mainly clinical and technical aspects; hence, the absence of a focus on performance management (PM) represents the main weakness of this function. Thus, starting from the current body of literature in the fields of PM and HT management, this work theoretically identifies how to design an HB-HTA function and which the main relevant evaluation perspectives are. By explaining the implementation stages, it will be shown how HTA at the hospital level should be able to combine the different perspectives of business performance (financial and nonfinancial) with clinical needs.