Læknablaðið - 15.09.1982, Blaðsíða 28

214
LÆKNABLAÐIÐ
A. Wilfried Wahba
MEDICAL TECHNOLOGY ASSESSMENT
National assessment programmes of medical
technologies are proposed as part of a nation-
al health care policy. Methods for the control
of medical technologies include:
Development of assessment procedures, reim-
bursement and capital investment limitations,
market entry licencing, issuing of standards
for every technology, certificate of need sy-
stem, diffusion of technical recommendations,
guidance for development and large-scale
production, manpower training policies, edu-
cation of user and general public and a
coordinated research policy.
1. Introduction
Medical technologies used in health care
systems tend to require additional personnel,
greater skills, and continuing new types of
equipment, thus giving rise to higher costs.
Although in most industries the technology
problem is one of not getting innovations on
to the market rapidly enough, in health care
there is concern that diffusion may often be
too rapid and insufficiently assessed.
Any system providing health care and
designed to allocate resources must encour-
age the use of technically safe, clinically
relevant and economically efficient medical
technologies. This requires the establishment
of a national medical technology policy.
National medical technology policy strategies
— Establishment of needs and priorities
— Guidance in research and development
— Identification of assessment centres and partici-
pation in a network
— Support of utilization studies
— Study of social, economic, ethical and legal
impacts
— Dissemination of information
— Coordination in training and development of
manpower
A. Wilfried Wahba, M.D., Ph.D., F.R.C. Path. WHO Region-
al Office for Europe, Copenhagen
The different facets of such a policy form the
basis for improved concerted national action
with regard to the planning, development,
organization, management, training and edu-
cation, assessment, diffusion of information,
purchase, and utilization of medical technolo-
gies.
2. Definitions
Biomedical technologies are those drugs, devi-
ces or procedures used in the delivery of
health services for prevention, diagnosis and
treatment of illness and in rehabilitation (ad-
apted definition, issued by the Nordic Countri-
es/WHO Consultation Meeting, held in 1980.
In the present paper drugs are not included.
Technology assessment is a form of re-
search, analysis and evaluation that attempts
to examine the various impacts of a particular
technology on the individual and society in
terms of the technology’s safety, efficacy,
effectiveness, and cost-effectiveness, and its
social, economic and ethical implications and
to identify those areas requiring further re-
search, demonstrations or evaluations. (Opera-
tional definition issued at the EMRC/
NCHCT/WHO Symposium on the Assess-
ment of Medical Technologies, held at WHO
Regional Office for Europe, September 1981).
Devices are defined as any physical means,
not being a drug, used in the delivery of
prevention, diagnosis, treatment of illness and
rehabilitation.
Procedures are defined as a combination of
health care provider skills and techniques
which may or may not employ physical means
as drugs and devices or a combination thereof.
The latter two definitions are based on the
Office of Technology Assessment (OTA) pub-
lication: the assessment of efficacy and safety
of Medical Technology (Libr. Congress USA;
nr. 78-600 117).
3. Components
3.1 Laboratory services with its specialized
disciplines of clinical chemistry, haematology,