Læknablaðið - 15.09.1982, Page 39

LÆKNABLADID
219
control through chanelling projects to techno-
logy evaluation, cost-benefit assessment and
the promotion of clinically relevant innova-
tions.
7. Medical technology assessment in the
European Region of WHO
There are several reasons for the continuously
growing interest in the assessment of medical
technologies. One of the most obvious is the
contribution of medical technology to the
rising cost of health care and the great
demands being made on society’s limited
resources. Another reason is the inadequacy
of knowledge concerning the impact of vari-
ous medical technologies on the health status
and quality of life of individuals and the
community. A third feature is the frequently
changing and expanding indications for cer-
tain medical technologies, which may often
lead to overuse, misuse, and thus result in
ineffectiveness. Underuse should also be con-
sidered under certain circumstances when too
many technologies of the same nature become
available in a defined geographic area.
Medical technology problems
— Real needs — Available means
— Insuffícient Assessment at national and interna-
tional levels
— Appropriate utilization: over-, mis-, under-use
— Insuffícient guidance in development: research
— production
— Cost-consciousness: Lack of adequate education
and training
— Necessity for adaptation to »Shift«
— Public, professional and industriai pressures
In spite of the urgency of the problem, limited
initiatives are taken at various national levels
and assessment tends to be confined to special
studies of individual techniques or apparatu-
ses, voluntary authorizations of devices, at-
tempts at standardization of equipment and
sometimes simply the examination of defects,
complaints and accidents; all of this may result
in some recommendations which may or may
not be followed by the various institutions
concerned.
In some countries the purchase and main-
tenance of equipment is practised at national
or regional levels and in others this is not
possible. Legislation and statutes are very
often in principle, but rarely in practice,
expected to give guidance for technology
purchase and applications. Practically all insti-
tutes assessing the safety and efficacy of
medical technologies have a purely consulta-
tive function and entirely lack authoritative
powers. While technical evaluations are ge-
nerally performed for various types of equip-
ment, utilization studies of the technologies,
which should be part of the assessment
procedure, are practised on a limited scale.
Some health authorities in the Region have
contractual agreements with specified institu-
tions regarding the quality assurance of cer-
tain apparatuses and purchase recommenda-
tions are circulated on the basis of these
results. The situation can be summarized thus:
there are limited efforts but a wide realization
of need for a comprehensive assessment.
8. Technology assessment network
In the present programme of the Regional
Office for Europe of WHO a project will
develop and implement a health care techno-
logy assessment network by linking selected
national institutes capable of ensuring techni-
cal, clinical and economic assessments of new
equipment and technologies. The main criteria
for the choice of these institutes is their
present capability in performing assessments.
Whenever possible, evaluation of presently
used and insufficiently assessed equipment will
also be considered. These institutes will also
be requested to engage in utilization studies at
various levels of health care. The neutral
nature of these selected testing centres would
ensure that objective, non-biased and com-
plete information is made availabld to prospec-
tive consumers.
The work of these institutes will be coordi-
nated by the Regional Office of WHO and the
information gathered will be diffused to the
Member States. The institutes participating in
the network will thus provide a service which
will not only be available to European Mem-
ber States but which could also be provided to
other Regions and Countries.
BIBLIOGRAPHY
1. Banta, H.D. Assessing the social impacts of
medical technologies. Journal of community
health, 1978; 5:245.