The challenge of organisational assessment in HTA across Europe. Building a new framework

Background Organisational aspects influence the behaviour of healthcare professionals and managers and may help to overcome the barriers in the implementation of new health technologies. However, organisational domain is often under-represented or absent when Health Technology Assessment (HTA) reports are built. This study was aimed to explore the organisational assessment in HTA and build a new framework for applicative experience after the comparison with EUnetHTA\u2019s CoreModel 3.0. Methods A literature review was performed by extracting full HTA reports through the websites of members of International Network of Agencies for HTA and the aspects relating to the organisational assessment were analysed. A quantitative and qualitative analysis was performed on the retrieved reports and the results were compared with a framework of 5 domains and 15 subdomains from CoreModel. A Multiple Correspondence Analysis (MCA) was carried out in order to evaluate the power of CoreModel and identify new common domains to guide the organisational assessments in HTA reports. Results The assessments of organisational issues in the reports were significantly heterogeneous and less common than the others. When included, domains and subdomains of CoreModel were not covered homogeneously by the organisational assessments (representation level varied from 19% to 62%). Through MCA and the subsequent clustering of items a new framework was developed, based on 3 new composite indicators. Conclusions This study analyzed the relevance of organisational assessments in current literature and the challenges of promoting a global approach to the matter. According to the current state of the research, we proposed a new methodology to cover the most relevant aspects of organisational appraisal according to new, more homogeneous domains and a less context-oriented approach to encourage health professionals across Europe to perform organisational analysis and better fulfill the needs of future HTA research. Key messages: Organisational aspects in health technology assessment are important for the implementation of new health technologies, but their analysis is often under-represented or absent in HTA reports. A new framework could help to promote the appraisal of HTA organisational aspects in a more coherent and homogeneous way, overcoming the differences in healthcare settings and contexts across Europe