A Systematic Literature Review of Hospital-Based Health Technology Assessment

Background: Technological innovation has risen exponentially and hospitals are currently at the forefront of this advancement. However, they do not have reference guidelines to assess the value of healthcare technologies. Health Technology Assessment (HTA) is the dominant discipline used to evaluate healthcare technologies, but the available reference frameworks refer mostly to the healthcare system perspective. Since hospitals are very peculiar organizations with objectives and constraints different from nations and regions, Hospital- Based HTA (HBHTA) gained momentum in recent years. However, reference frameworks and guidelines to conduct it are still missing. Objective: Our aim was to gather the published literature about HBHTA in order to propose a novel overarching framework with relevant domains and criteria to evaluate healthcare technologies. Materials and Methods: We carried out a Systematic Literature Review implementing on Scopus the following query: (("technology assessment" OR "HTA") AND ("hospital")). Articles were selected from 2006 onwards, being 2006 the year in which mini-HTA, the cornerstone of HBHTA was developed. Inclusion criteria were relatively broad, as articles focusing on the assessment of innovative medical devices from the hospital perspective were included. Studies assessing pharmaceutical interventions were excluded. Out of 1,523 the full-text papers assessed for eligibility were 248 and, finally, the articles included in the review were 49. Results: In the results section a descriptive analysis of the technologies evaluated by the included studies is presented, exhibiting that the majority of the studies evaluated large equipment. Moreover, a framework for evaluating healthcare technologies from the perspective of a hospital. The framework is comprehensive of domains and criteria used to perform the assessment, together with an explanation of them; all the studies were positioned according to the criteria. Conclusions: Our study produces evidence and future suggestions about the application of HBHTA, being significant both from an academic and a practitioner point of view.