hta in austria ekonomika zdravotnictví, standardy kvality zdravotní péče a hta, praha
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HTA in Austria Ekonomika zdravotnictví, standardy kvality zdravotní péče a HTA, Praha May 6, 2010. HTA in Austria – presentation outline. Features of the Austrian health care system Barriers for evidence based decision making - PowerPoint PPT PresentationTRANSCRIPT
HTA in Austria
Ekonomika zdravotnictví, standardy kvality zdravotní péče a HTA, PrahaMay 6, 2010
Organigramm
ÖBIG Forschungs und Planungsgesellschaft mbH (non profit) ÖBIG Beratungs GmbH (for profit)
Tochtergesellschaften:
ÖBIG – Österreichisches Bundesinstitut für Gesundheitswesen
Prävention
Gesundheitsberichterstattung
Gesundheitsplanung
Gesundheitsberufe
Gesundheitsökonomie
Transplantations und Transfusionswesen
Alten , Langzeit und Psychosoziale Versorgung
Dr. Arno Melitopulos
BIQG – Bundesinstitut für Qualitätim Gesundheitswesen
Struktur und Prozessqualität
Qualitätsregister und Ergebnisqualität
Qualitätsberichte und Gesundheitsinformation
Qualität und Wirtschaftlichkeit
Eva Maria Baumer, MPH
FGÖ – Fonds Gesundes Österreich
Projektförderung und entwicklung für Gesundheitsförderung
Qualitätsentwicklung und Fördermanagement
Fort und Weiterbildung,(Inter )Nationale Vernetzung
Information und Aufklärung
Selbsthilfe (SIGIS)
Mag. Christoph Hörhan
Gesundheit Österreich GmbH / Dr. Arno Melitopulos
HTA in Austria – presentation outline
Features of the Austrian health care system
Barriers for evidence based decision making
From eminence to evidence ? – a national HTA strategy for Austria
aims
current status
examples of impact
challenges.
Features of the Austrian Health Care System
social health insurance (98% of population covered)
federal structure
delegation of competencies (planning, coordinating, financing)
to self-governing stakeholders in the social insurance
to cross-stakeholder assemblies at federal and provinces levels
fragmentation
Out-patient sector: regulatory responsibilities at federal government, directly financed by social insurance
In-patient sector: implementation and enforcement at 9 provinces, financed by social insurance and taxes bias toward hospital care
Out-patient and rehabilitation: organized by negotiations between health insurance funds & chambers of physicians and pharmacists.
Federal administration
Ministry of Health
regional administrations
Out-
patients
In-
doctors/-chambersother health professionals
Federation of Social security Funds
Federal health commission
Social Insurance Funds
Serv
ice
nego
tiatio
ns
Contracts on implementation competence shift
Serv
ice
nego
tiatio
ns
Regional „Health Platforms“
hospitals/hospital carriers
Attempts to Reform the Health Care System
deal with cost containment and structural reforms
efforts toward decision-making and financing
effective across all levels and
more evidence based
linkage of quality assurance in decision making to HTA and EbM (Federal Law for establishing Quality in Health Care 2006).
How the Health Care System can benefit from HTA
HTA
provides rational decision support
rationalizes negotiations
helps to resist lobbying
helps to increase quality in health care
does not absolve politicians from decision making (based on ethic, social, demographic and allocation fairness aspects)
Aims of a national Austrian HTA strategy
Optimize decision making in the health care system on general levelby the use of scientific instruments
increase knowledge and acceptance to force commitment
make HTA obligatory and binding in decision-making process
provide for financial and personal resources
control quality in HTA production by common methods and standards
avoid duplication and use synergies (national networks, peer groups, International co-operations )
disseminate results: HTA information to all interested stakeholders
specialist advice and co-operation
clearing house, information platform
Ministry of Health
UAG Qualität
Fed agency of health
development, implementation and
factual control HTA work groupFed. state / provinces /
sozial insurance
National HTA Strategy
Gesundheit Österreich Federal institute for quality in
health care system
HTA expert poolfrom Austrian and
German HTA organisations
Current activities within the national HTA strategy
nationwide standards for methods and processes
harmonised peer review process
public topic selection and prioritization process as a pilot http://www.goeg.at/de/Bereich/HTA-Themenfindung.html
seminar series for stakeholders
national HTA-register of completed, ongoing and planned reports, integrated into a European meta search engine
annual HTA-symposia
freely accessible electronic guide to international HTA information and ressources http://hta-guide.biqg.at
EBM Review Center – Med UNI Graz
GÖG/BIQG
Department for evidence based medicine
Donau UNI Kremse.g. for IQWiG
e.g. for AHRQ
e.g. for DIMDI
First Austrian HTA-Symposium on May 3rd 2010
Current impact of HTA in Austria: non-systematic
Examples
investigational in-patient services (“MELs”) applied for the health service basket – Federal Health Agency
horizon scanning on emerging cancer drugs – MoH + hospital carriers
deficiency concerning para-medical professions - MoH
prevention programs: e.g. HPV immunisation - MoH
screening tests: HIV test for pregnant - MoH
out-patient cardiovascular rehabilitation (phase III) - social insurance
provision planning of positron emission tomography - hospital carrier
Which aspects are currently applied in Austria
effectiveness
additional benefit
Alternatives
increasing quality in health care
no thresholds (benefit – harm)
no economic criteria (no cost saving reasons (yet), no allocation alternativs)
no procedure for disinvestment issues
not used for regulation mechanism for future research
Crucial Issues to achieve a vital national HTA-strategy
We still need
agreement on transparent decision making at the key stakeholders
systematic use of the methods: sticking to the process, using the results
formally integration into decision making processes
assured adequate financing.
Where am I?
You’re 30 metres above
the ground in a balloon
You must be a researcher
Yes. How did you know?
Because what you told me is
absolutely correct but completely
useless
You must be a policy maker
Yes, how did you know?
Because you don’t know where you are, you don’t know where you’re going, and now
you’re blaming me
The problem
MMag. Elisabeth Breyer
Stubenring 6
1010 Wien, Österreich
T: 1234567-112
F: 12345678
www.goeg.at
Contact