Budgeting and health technology assessment: first evidence obtained from proposal forms used to submit the adoption of new technology.
OBJECTIVE
The aim of this study was to benchmark the proposal forms used by a sample of Italian hospitals to inform the budget process for the adoption of new technology to understand the relationship with the guidelines provided by the Health Technology Assessment (HTA) literature.


METHODS
A literature review was first undertaken to identify the frameworks developed to support decision making regarding new technology at a hospital level. A checklist of criteria drawn up according to five main perspectives (technology, patient, organization, economics, and level of evidence) has been formalized to review and compare the collected proposal forms.


RESULTS
The "technology" perspective appears to have been broadly covered. The "patient" perspective has focused to clinical issues and partially neglects other dimensions such as patient satisfaction and potential adverse events. The "organization" dimension has paid little attention to change management. The "economics" dimension has been broadly covered, even though a sensitivity analysis has not been considered. The "level of evidence" that is required for submitting the proposal form is little.


CONCLUSIONS
The proposal forms used to inform the budget process regarding the adoption of new technology are accountable for a limited set of dimensions from among those proposed in literature. Further research is required to understand how to render technology assessment multidimensional, multidisciplinary, evidence-based, and accountable at a hospital level.
Lettieri
Emanuele
E
Department of Management, Economics and Industrial Engineering, Politecnico di Milano, 32 Piazza Leonardo da Vinci, Milan, Italy. emanuele.lettieri@polimi.it
Masella
Cristina
C
Nocco
Umberto
U
D002017:Budgets / Q000458:organization & administration*; D019317:Evidence-Based Medicine; D006292:Health Priorities / Q000191:economics; D006739:Hospital Administration / Q000191:economics*; D017721:Hospital Costs; D006801:Humans; D007558:Italy; D017060:Patient Satisfaction; D013673:Technology Assessment, Biomedical / Q000191:economics / Q000458:organization & administration*; D016896:Treatment Outcome