Appropriate incentives for the use of health technology assessment in health care –decision making in the Kumasi metropolis.

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June, 2019
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The call for optimization of resources has been reinforced by the WHO‟s efforts at encouraging the use of health technology assessment to inform public policies, establishment of an institutional framework for decision-making based on health technology assessment, strengthening human resource capabilities, promotion of the production of evidence and dissemination of information and rational use of health technologies. Countries are at different levels of conceptualization and incorporation of HTA in health care decision making. The study therefore examined the incentives and disincentives for the usage or non-usage of health technology assessment in making decisions in the healthcare decision in the Kumasi metropolis. An exploratory study design with mixed method of data collection with 107 health staff was conducted Quantitative data was analysed at univariate, bivariate and multivariate levels. Logistic regression was run to assess the strengths of selected variables on the dependent variables. The qualitative data was analysed using thematic content analysis. The result showed that there is no existing policy on HTA guiding health care decision making in Ghana. The absence of HTA policy is partly attributed to the low level of capacity in terms of knowledge training and skill development in HTA. Most health decisions are made with inputs from effectiveness, cost-benefits, efficacy and safety of technologies in making decisions studies. The decision making process is largely bottom-up approach. The decision making process is initiated by patients or users of the facility, and hence form the basis as inputs for central management decisions. The decisions of the facilities are made in line with the strategic plans of the health facility, the procurement act and the procurement plans for the year. The decision making process are perceived to result in high effect on patient recovery time, patient survival, deliveries, reduction in errors and quick delivery of services to clients. The areas in the health facilities that HTA related decisions are occasionally and accidentally used include drugs, biologics, devices, equipment supplies and medical surgical procedures. The incentives for using HTA in health care decision making were value for money, quality of life, price, emerging pathogens, avoidance of malpractice, financial incentives and provider competition. The rest were public demand, the provision in the procurement law, efficient use of government funds, effectiveness of health treatment, transparency, improvement in patient care, sustainability and environmental friendliness. The perceive disincentives for HTA policy in health care decision making in Ghana include inadequate expertise, internal politics, ignorance, lack of funds, complex administrative charges, lack of official strategic plan, unavailability of information and lack of proper structure. The study recommends development of HTA policy capacity building to facilitate its incorporation in healthcare decision making in Ghana,.
A thesis submitted to the department of Health Policy, Management and Economics, College of Health Sciences in partial fulfilment of the requirements for the award of Masters of Public Health degree in Health Services Planning and Management.
Technology assessment in health care, Kumasi metropolis