International comparison of the definition and the practical application of health technology assessment

TLDR

HTA is a policy research approach evaluating the social consequences of technology use, with international institutions adapting its definition to local contexts and Denmark adopting a comprehensive model covering clinical, economic, patient, and organizational aspects. This study examines how HTA application varies among leading countries and compares Danish HTA reports to foreign ones. The authors reviewed 433 HTA reports from 1989–2002 across eleven Danish and eight foreign institutions, analyzing each report’s focus on the four main aspects and how each aspect was addressed. The review found that procedures were the most frequently assessed technology type and literature reviews were the predominant analysis method, yet only about half of HTAs included policy recommendations; overall, HTAs emphasize clinical aspects while under‑examining economic, patient, and organizational dimensions, with Danish reports showing a broader scope and greater attention to patient and organizational factors.

Abstract

Objectives: Health Technology Assessment (HTA) is defined as a policy research approach that examines the short- and long-term social consequences of the application or use of technology. Internationally different institutions have translated this definition to local contexts. In Denmark, HTA is comprehensive with focus on four aspects of the problem in question (technology [clinical evidence], economy, patient, and organization). The objective of this study is to study how the application of HTA differs across leading countries and to study the extent to which Danish HTA reports differ from foreign HTAs. Methods: A sample of 433 HTA reports published in the period 1989–2002 by eleven leading institutions or agencies in Denmark and eight other countries were reviewed. We looked at the characteristics of the HTA with respect to focus on the four main aspects and the manner in which each aspect has been approached. Results: The study shows health technology procedures to be the most common type of health technology assessed in HTAs and literature review to be the most often used method of analysis. Policy recommendations are only present in approximately half of the HTA reports. Conclusions: In the HTAs one generally sees a great focus on the clinical aspect of health technologies, leaving the economic, the patient-related, and the organizational aspect much more unanalyzed. The Danish HTAs generally have a wider scope than HTAs produced in other countries and tend to focus more frequently on patient-related and organizational dimensions.