Hospital-Based HTA Institutionalization: A Case-Study at a Unit of the Brazilian Health System

OBJECTIVES: The continuous flow of new health technologies and the limited financial resources of health systems, represents significant challenges for hospital units. In Brazil, a high-complexity cardiovascular unit of the Ministry of Health, with its own budget and a Health Technology Assessment (HTA) unit, had not yet begun the process of institutionalizing HTA validated by the general management of the institution.

METHODS: A study was developed, started with a literature review on hospital HTA (HB-HTA) in Brazil, searching on databases, with supplementary searches for legislation, theses and dissertations. The unit's organizational processes were then mapped through team meetings involving professionals from different sectors related to the acquisition of new technologies, and through the analysis of internal documents. The objective of the mapping was to identify the fundamental requirements for the development of the process, with the intention of enhancing and reinforcing HB-HTA. Following the analysis, an algorithm was created and aligned with the management and coordination of the sectors involved, encompassing workflows, operational protocols, and a legal framework, including an appointment ordinance and internal regulations.

RESULTS: The successful implementation of HB-HTA necessitates a multidisciplinary and collaborative approach involving healthcare professionals, hospital managers, and members of the HTA unit. Transparency, methodological rigor, and effective communication were essential to gain the trust of stakeholders and ensure acceptance and adoption of the HTA unit's recommendations. The availability of qualified human resources, adequate infrastructure, and institutional support were key to the effective functioning of the HTA unit.

CONCLUSIONS: The implementation of the algorithm in this referral center will facilitate more transparent and evidence-based management, thereby improving the quality of healthcare. Hospital managers, healthcare professionals, and even patients will be able to access evidence-informed decisions in order to enhance operational efficiency and ensure the proper allocation of resources.