Can our health services be saved by technology evaluation? The Quebec experience.
The finances to support our health services at their present level are lacking, and much of the shortage is due to new health technologies. Through the utilisation of technology assessment (TA), it is hoped that we may be able to eliminate useless technologies and that the money so saved will allow us to maintain our health care services intact. Such hopes are exaggerated. The uses and limitations of TA are reviewed in the light of recent experience gained with the Conseil d'évaluation des technologies du Québec. Technology assessment has only limited value in exposing ineffective technologies. More often, it can illuminate inappropriate use of technologies. However, its real value lies elsewhere, namely in making difficult choices between different technologies. An example is the choice between expensive, low osmolar contrast media in radiology and the cheaper, high osmolar material which causes more frequent reactions. Credible estimates of how much benefit will result from the commitment of how many extra dollars can facilitate such decisions. However, the user must clearly understand the limitations of cost-effectiveness estimates, which should never be used for policy purposes without full knowledge of all the qualifiers on which the estimates depend.
McGregor
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Conseil d'évaluation des technologies de la santé du Québec, Montreal.
D002170:Canada; D017048:Health Care Costs; D018166:Health Care Reform; D006296:Health Services; D011792:Quebec; D013673:Technology Assessment, Biomedical