我国开展医院卫生技术评估的路径与策略

随着我国卫生医疗领域改革的不断深入和新版《医疗技术临床应用管理办法》的实施,医院在卫生技术准入和管理中的作用逐渐加强,对以医院卫生技术评估为代表的循证支持决策的需求也在增加。本文基于对我国开展医院卫生技术评估试点医院评估项目问题和经验的总结,并结合国际上典型国家的理论基础和实践经验,探索提出我国医院卫生技术评估的发展路径:一是技术路径,包括评估的技术类型、评估流程和评估结果等,并从五个维度提出了我国开展医院卫生技术评估需要重点关注的十个因素;二是治理路径,即如何引入和引导利益相关方以独立的方式参与评估。我国开展医院卫生技术评估试点项目和理论研究的发展目标是尽快探索出符合我国国情的医院卫生技术评估方法、流程及相关制度,发展策略是加强国家指导和与全国医院绩效考核工作相结合以强化认知共识;与医疗联合体建设相结合推进决策转化应用;注重在医院内部通过成果实施、传播和升华培养评估文化;加强卫生技术评估决策转化监管与评估。

The path and development strategy of introducing hospital-based health technology assessment into Chinese hospital management

At present, with the deepening of the reform in the field of health care in China and the release of the new clinical management regulations, the role of hospitals in health technology entry decision-making and management is gradually strengthened, and the demand for evidence-based support decision-making represented by Hospital-based Health Technology Assessment(HB-HTA) is also increasing. Based on the summary of the problems and experiences of the pilot hospital HB-HTA projects in China, and combined with the theoretical basis and practical experience of typical countries in the world, this paper puts forward two development paths of HB-HTA in China. The first is technological path, including the assessment technology types, assessment process and the results. The paper puts forward ten factors that need to be paid attention to in developing HB-HTA in China from five dimensions. The second is the governance path, that is, how to introduce stakeholders to participate in the assessment activities in an equal and independent manner. The goal of developing HB-HTA pilots in China is to explore the methods, processes and related systems of HB-HTA in line with China''s national conditions. The development strategy is to strengthen cognitive consensus using means such as HB-HTA national guidance; promote HB-HTA knowledge transfer along with the construction of medical consortium; pay more attention to the cultivation of HTA culture in hospitals; and strengthen the evaluation of the decision transformation of HB-HTA results.