Appropriate incentives for the use of health technology assessment in health care –decision making in the Kumasi metropolis.
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Date
June, 2019
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Abstract
The call for optimization of resources has been reinforced by the WHO‟s efforts at
encouraging the use of health technology assessment to inform public policies,
establishment of an institutional framework for decision-making based on health
technology assessment, strengthening human resource capabilities, promotion of the
production of evidence and dissemination of information and rational use of health
technologies. Countries are at different levels of conceptualization and incorporation
of HTA in health care decision making. The study therefore examined the incentives
and disincentives for the usage or non-usage of health technology assessment in
making decisions in the healthcare decision in the Kumasi metropolis. An
exploratory study design with mixed method of data collection with 107 health staff
was conducted Quantitative data was analysed at univariate, bivariate and multivariate
levels. Logistic regression was run to assess the strengths of selected variables on the
dependent variables. The qualitative data was analysed using thematic content
analysis. The result showed that there is no existing policy on HTA guiding health
care decision making in Ghana. The absence of HTA policy is partly attributed to the
low level of capacity in terms of knowledge training and skill development in HTA.
Most health decisions are made with inputs from effectiveness, cost-benefits, efficacy
and safety of technologies in making decisions studies. The decision making process
is largely bottom-up approach. The decision making process is initiated by patients or
users of the facility, and hence form the basis as inputs for central management
decisions. The decisions of the facilities are made in line with the strategic plans of
the health facility, the procurement act and the procurement plans for the year. The
decision making process are perceived to result in high effect on patient recovery
time, patient survival, deliveries, reduction in errors and quick delivery of services to
clients. The areas in the health facilities that HTA related decisions are occasionally
and accidentally used include drugs, biologics, devices, equipment supplies and
medical surgical procedures. The incentives for using HTA in health care decision
making were value for money, quality of life, price, emerging pathogens, avoidance
of malpractice, financial incentives and provider competition. The rest were public
demand, the provision in the procurement law, efficient use of government funds,
effectiveness of health treatment, transparency, improvement in patient care,
sustainability and environmental friendliness. The perceive disincentives for HTA
policy in health care decision making in Ghana include inadequate expertise, internal
politics, ignorance, lack of funds, complex administrative charges, lack of official
strategic plan, unavailability of information and lack of proper structure. The study
recommends development of HTA policy capacity building to facilitate its
incorporation in healthcare decision making in Ghana,.
Description
A thesis submitted to the department of Health Policy, Management and Economics, College of Health Sciences in partial fulfilment of the requirements for the award of Masters of Public Health degree in Health Services Planning and Management.
Keywords
Technology assessment in health care, Kumasi metropolis