title: Stakeholders involvement by HTA Organisations: why is so different?
abstract: OBJECTIVE
  To investigate stakeholder involvement by Health Technology Assessment Organisations (HTAOs) in France, Spain, England and Wales, Germany, Sweden, and The Netherlands and to examine whether this involvement depends on (i) the administrative tradition and the relevant conception of the relationship between state and society (contractarian and corporative vs. organic), (ii) the general structure of the healthcare system (HCS) (Bismarckian vs. Beveridgian system), and (iii) the role of Health Technology Assessment (HTA) and HTAOs in the HCS.
  
  
  METHODS
  Given the exploratory nature of the study, we considered interviews based on semi-structured questionnaires the most appropriate data-gathering technique. The interviews were administered to 16 key personnel in the HTAOs concerned. We have also carried out a literature review on HTAOs and stakeholders (1999-2011) using PubMed, Ebsco, JSTOR and Wiley Science.
  
  
  RESULTS
  In contractarian and (to a lesser extent) Bismarckian models, stakeholders are more involved. The administrative tradition and the HCS appear less important when the HTA is binding and used for regulatory purposes. In such situations, stakeholders are more intensively involved because their participation provides an opportunity for HTAOs to achieve consensus and legitimacy in advance.
  
  
  CONCLUSIONS
  Despite the limitations of the research (we did not conduct multiple interviews for each HTAO, and key informants were not always available) and its exploratory nature, we can conclude that models of stakeholders involvement cannot easily be transferred from one country to another due to the importance of national administrative traditions and the characteristics of HCSs.
authors.affiliation: CERGAS (Centre for Health and Social Care Management), Università Bocconi, Via Roengten 1, 20136 Milan, Italy. marianna.cavazza@unibocconi.it
authors.forename: Marianna
authors.initials: M
authors.lastname: Cavazza
authors.forename: Claudio
authors.initials: C
authors.lastname: Jommi
mesh_terms: D020811:Biomedical Technology / Q000458:organization & administration*; D003659:Decision Making, Organizational; D019981:Health Care Sector / Q000458:organization & administration; D006291:Health Policy; D006801:Humans; D007407:Interviews as Topic; D011050:Policy Making; D011795:Surveys and Questionnaires; D013673:Technology Assessment, Biomedical / Q000458:organization & administration*