Objectives: Hospital-based health technology assessment (HB-HTA) is becoming increasingly relevant because of its role in managing the introduction and withdrawal of health
technologies. The organizational arrangement in which HB-HTA activities are conducted depends on several contextual factors, although the dominant models have several
similarities. The aims of this study were to explore, describe, interpret, and explain seven cases of the application of HB-HTA logic and to propose a classification for HB-HTA
organizational models which may be beneficial for policy makers and HTA professionals.
Methods: The study was part of the AdHopHTA Project, granted under the European 7th Framework Research Programme. A case study methodology was applied to analyze seven
HB-HTA initiatives in seven countries, with collection of qualitative and quantitative data. Cross-case analysis was performed within the framework of contingent organizational
Results: Evidence showed that some organizational or “structural” variables, namely the level of procedure formalization/structuration and the level of integration with other HTA
bodies at the national, regional, and provincial levels, predominantly shape the HB-HTA approach, determining a contingency model of HB-HTA. Crossing the two variables, four
options have emerged: integrated specialized HTA unit, stand-alone HTA unit, integrated-essential HTA, independent group unit.
Conclusions: No one-best-way approach can be used for HTA at the hospital level. Rather, the characteristics of HTA models depend on many contextual factors. Such
conceptualization may aid the diffusion of HB-HTA to inform managerial decision making and clinical practice.
- Health Technology Assessment
- Organizational Models