Implementation of Health Technology Assessment Work in a Hospital in Kazakhstan

Abstract

Objectives: The aim of this study was to implement health technology assessment (HA) in the First General City Hospital in Astana, Kazakhstan. Methods: We organized trainings to familiarize hospital staff with the purpose and details of HTA. An HTA committee was established, with representation from hospital physicians and managers, and criteria for prioritization of health technologies determined. Clinical departments of the hospital were asked to prepare applications for new technologies for their services. Results: The HTA committee reviewed five applications and selected a technology from one of these, on single incision laparoscopic surgery (SILS), for assessment. A short HTA report on SILS was prepared, covering its safety, clinical effectiveness, and cost effectiveness. The report was used to support a request to the Department of Health for additional funding to implement this technology within the hospital. This funding was approved and SILS was established in several hospital departments. Conclusions: This successful initial experience with HTA has paved the way for its routine use by the hospital for informing decisions on the procurement and use of new health technologies. METHODSThe overall approach to development of the HTA program is shown in Figure 1.We first studied models of hospital -based HTA that had been used in different countries, obtaining information from various databases including those available through HTAi, PubMed and INAHTA.Consultation was held with hospital physicians and administrative staff to provide them with details of the role and scope of HTA. Training workshops were organized for 5 physicians (as the experts who used new technologies in the hospital), hospital economists and managers to examine organizational aspects of technology implementation.After completion of initial training we created a hospital HTA Committee, which was comprised of senior doctors, hospital managers and hospital economists, following a model considered by an HTAi Interest Sub-Group (8). Details of each stage of the HTA process were discussed with the committee.Prioritization criteria for hospital projects were formulated in discussion with the HTA Committee, having regard to accepted HTA practice (9). The criteria selected were budget impact, clinical effectiveness, safety, and availability of alternativetechnology.An application form was developed for submitting proposals on technologies which physicians or other stakeholders wished to include or exclude from hospital services. With members of the hospital's innovative technology department (ITDH), which reports directly to the Chief of Hospital, we asked each clinical department of the hospital to prepare applications. RESULTSWithin a month, applications had been submitted for 15 technologies to provide a range of services at the hospital. Information in the applications was analyzed and brief details on the technologies were sent to members of the HTA Committee. Points considered included demands for the technology in the region, wha...

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