Self-reported healthcare decision-makers’ attitudes towards economic evaluations of medical technologies

ABSTRACT

Background: Increasing costs have generated concern among governments and healthcare providers who have realized the need for cost containment measures and more efficient resource utilization. Health economics is one potential source of information that can make healthcare more efficient.

Scope: This review article summarizes the published literature on self-reported attitudes of healthcare decision-makers towards economic evaluations of medical technologies and examines the extent to which economic evaluations are used in health policy decisions.

Methods: A systematic literature review of published English language studies was conducted using MEDLINE, EMBASE, and HEED from January 1995 to December 2007.

Findings: Fifty-five articles investigated the use of economic evaluations on three levels of decision-making: central, local, and physician level. Results indicate the use of economic evaluation information increased from limited/minor to moderate use. The influence of economic evalu-ations increased with the level of centralization of healthcare system. Barriers to use health economics research varied across levels and included health economics research-related barriers such as timely availability, lack of credibility, insufficient methodological quality and decision-context-related barriers including limited decision makers’ knowledge, inflexibility in healthcare budgets and variability among healthcare organizations.

Conclusions: For consistent policy-making it is important that similar recommendations for cost-effective interventions and programs are developed at all levels and that implementation is promoted by incorporating the appropriate incentives in healthcare provision.

Key words: :

• Decision-making
• Health economics
• Health policy
• Priority setting
• Research utilization

Acknowledgements

Declaration of interest: This study did not receive funding. The authors declare that they have no conflicts of interest with respect to the contents of this article.

The authors would like to thank the anonymous reviewers for their useful comments on previous versions of the manuscript.