Running a hospital in a sustainable yet effective way is the main challenge facing the hospital manager today. Health technologies are important for professionals who want to stand out.
Why health technologies matter
Regardless of changes in the epidemiological profile of populations, such as the one we have been experiencing since 2020 with the emergence of Covid-19, optimizing financial resources in light of the available health technologies is a task that arises every day.
In fact, in recent decades there has been major technological development in healthcare and, with it, an increase in costs, since new technologies generally bring greater added value. In addition, in healthcare, new technologies generally do not replace others but are added to procedures already in use.
Looking only at medications, an important healthcare input, in 2019 alone there was a significant increase in new products on the market (about 44% compared to 2018).
What are health technologies?
Health technologies can be:
- Medications,
- Materials,
- Equipment and procedures,
- Organizational systems,
- Educational systems,
- Information and support systems,
Care programs and protocols.
Everything takes place through the means by which health care and attention are provided to the population (Ordinance No. 2,510/GM of December 19, 2005).
Health technologies in Brazil
In Brazil, there is a policy that sets guidelines and procedures for incorporating new technologies into the SUS (Brazil’s Unified Health System), the National Health Technology Management Policy.
This policy can also help the private sector, by providing elements for defining strategies in private hospitals and even criteria for managing Health Plans and Insurance.
According to the Ministry of Health, health technology management is the set of management activities related to the processes of assessment, incorporation, dissemination, management of use, and withdrawal of technologies from the health system.
Public x Private
In the public sector, in addition to the population’s health needs, managers must take into account the public budget and the responsibilities of the different levels of government (federal, state, and municipal).
In the private sector, the available budget is also a limiting factor. The challenge is to adopt and provide technologies that deliver results and are economically viable.
In general, it can be said that the incorporation of a new health technology should be based on scientific criteria and on cost-benefit-safety data.
SCIENTIFIC EVIDENCE TO SUPPORT HOSPITAL MANAGEMENT
Over the past two years, because of the Covid-19 pandemic, there has been much discussion about whether or not to use medications without proven efficacy. How important is scientific evidence, really?
Can clinical practice alone define the use of medications or the incorporation and availability of technologies?
The search for evidence to inform health decision-making is a movement that began in the 1990s with the aim of ensuring that patient care is based on the best and most up-to-date scientific evidence, resulting in the best possible outcome.
To that end, it relies mainly on the results obtained in clinical studies (Clinical Trials).
Integrating health technologies
In addition to the safety and efficacy of the new technology, a comparison must also be made between the technology in question and the technologies already incorporated into the service or health system, in order to identify the clinical and economic benefits the new technology provides.
New technologies may, for example, be as safe or effective as existing ones but reduce the patient’s days in the hospital, resulting in savings for the institution, the patient, and society as a whole.
TYPES OF ECONOMIC ANALYSES IN HEALTH
According to Canuto (2010), the set of analytical techniques that comparatively evaluates two or more technologies, programs, or actions through the systematic measurement of the costs and results of each is called Health Economic Evaluation.
There are 4 basic types of economic analysis in health: Cost-Benefit, Cost-Minimization, Cost-Effectiveness, and Cost-Utility.
Cost-Effectiveness analysis, one of the most widely used today, is based on evaluating the costs involved against the consequences (outcomes) of health programs or treatments.
In Epidemiology, outcomes are events (variables) that are monitored to assess the impact of a health technology. An outcome can be a cure, a clinical improvement, or even the number of life-years gained with a given procedure, treatment, or intervention.
Cost-Utility Analysis is considered an evolution of Cost-Effectiveness Analysis because it adds quality of life as a variable to be studied. With population aging, an individual’s quality of life is an important achievement from both an economic and a social standpoint
COST X QUALITY
Ensuring the best available technology at the lowest possible cost is the great challenge for the Hospital Manager. As explained, the newest and most expensive technology is not always the one with the best cost-benefit.
Different aspects must be considered when defining the services and products offered, including safety, efficacy, effectiveness, and efficiency.
A given technology must be effective in real-world situations, comply with current legislation, and have a cost that is viable and affordable.
The ability to work with the issues highlighted in this article should be developed throughout the entire professional training of the Hospital Manager.
