Research On Current Situation And Influencing Factors Of Knowledge Translation From Health Technology Assessment To Health Policy-making In China From The Perspective Of Researchers

[Background] Health Technology Assessment (HTA) originated in the 1960s in the United States. The overall goal of HTA is to provide information for policy-making through comprehensive analysis of safety, effectiveness, patient-oriented effects, costs, and cost-effectiveness, social, ethical and legal issues. Then different countries around the world began carrying out health technology assessment after that. A number of research institutions have been established and they’ve finished several related work in China since China introduced the concept of health technology assessment in the last century. However, the number of HTA researchers is still very small, and researchers’ability to do HTA still needs to be strengthened. Although China has been in the gradual stage of integration with HTA and health policy, the results of HTA were rarely applied into policy-making. HTA’s great potential value has not been found out, and its impact on the health sector has been still very limited.[Study Goal] This study aimed to describe the current situation of the development of HTA in China, the utilization of health technology assessment in China and decision-making state from the perspective of the researchers. In the meanwhile, the thesis also aimed to analyze the influencing factors and provide recommendations for HTA application in health policy in China by analyzing surveys of researchers and institutions, and the variation trend of literature number of HTA and case study.[Study Contents and Methodologies] Theoretical model was used to analyze current situation and influencing factors of knowledge translation from health technology assessment to health policy-making in China. Literature review, case study, quantitative study of Researcher Questionnaires, qualitative study of interviews of researchers and quantitative study of Research Institution Questionnaires were used to describe the current situation and problems of HTA in China. And interviews of researchers and quantitative study of Researcher Questionnaires were used to analyze the influencing factors of knowledge translation of HTA in China.[Main study results]1. Literature findingsThe number of HTA related literature is in a steady rise, and the amount of literature will continue to grow slowly in the coming years. Since the introduction of the concept of health technology assessment in the 1980s, HTA has been accepted after nearly a decade, and it is in a stage of rapid development in recent years. The number of HTA projects and sum of money of HTA projects are increasing among all projects of National Natural Science Foundation of China (NSFC) from 2009 to 2013. HTA had got more attention in medical domain, and the importance and necessity had been gradually highlighting. However, in health management and policy area, the growth rate of the number of HTA projects and sum of money of HTA projects were slower compare with the growth rate of all projects and sum of money of all projects, respectively. Therefore, in the area, HTA hasn’t got enough attention, and HTA researchers’passion needs to be further stimulated.2. Case study resultsOverall, the relevance between stents related literature and stents related policies are not obvious according to our study. Some stents related policies are relevant to cost related researches. However, we could not find the correlation. Therefore, fewer stents-related HTA applied into policies.3. Current situation results of Researcher QuestionnaireWe sent out 561 copies of questionnaires, and took back 382 valid questionnaires. The effective rate of surveys was 68.10%. At present, from the perspective of HTA researchers in China, the progress of HTA in China is smoothing, and the research and knowledge translation were in the stage of development. Researchers generally recognized that the importance of health technology assessments transforming to policy-making, and they would consider the possibility of knowledge translation when choosing topics of project. Most researchers approbated the interpretation ability of health technology assessment of policy makers, and most of them had strong willing to do knowledge translation. However, they lacked of confidence in knowledge translation, and they had few actions to achieve the goal. Only several of them knew the process of policy-making and they barely considered adjusting the express methods when they submitted the study results to policy makers. Most researchers thought that HTA studies which were done by them were scientific and practical. They had good communication link with policy makers in the process of goal setting, discussion of research methods, implementation, findings and report writing, and research institutions have good communication link with various stakeholders. They usually published articles in Chinese journals, and the highest level of knowledge translation was academic translation among all types of knowledge translation. However, the development of HTA was still in the academic stage, and the condition of policy translation was still rare. The results of HTA were rarely applied into policy-making, and HTA’s great potential value had not been found out, and its impact on the health sector is still very limited.4. Influencing factor results of Researcher Questionnaire The influencing factors were research time, communication situation in the process of report writing, language adjusting when submitting research results, draft policy paper utilization and knowledge of policy formulation process.5. Descriptive study results of Research Institution Questionnaire We sent out 13 copies of questionnaires, and took back 12 valid questionnaires. The effective rate of surveys was 92.31%. Most research institutions had done none or few HTA projects from 2009 to 2013. Only institution A had finished more than 10 HTA projects from 2009 to 2013. Only two research institutions had published more than 10 HTA papers from 2009 to 2013, and most research institutions had published none or few HTA papers from 2009 to 2013. Therefore, more attention needs to be paid in the area of HTA in the research institutions in China.6. Qualitative study results of researcher interviews Topic selection was mainly based on interests of researchers and policy needs. Most researchers had got authorized projects from policy makers. There were many communication ways, and abundant communication could make it easier to reach a consensus between researchers and policy makers, and impact knowledge translation in the end. Most researchers chose traditional translation methods, such as publishing papers in Chinese academic journals. Researchers generally believed that the language was very important in the translation process. Most researchers believed that the quality of health technology assessment study needed to be improved, and the health technology assessment in China was still in the preliminary stage.[Policy suggestions]1. Researchers and research institutions still need to strengthen action in order to facilitate policy-making translationAt present, researchers and research institutions in China have positive attitude in health technology assessment cognitively, but they still lack motivation. To solve this problem, researchers should give full consideration to the needs of researchers working characteristics and decision making needs; strengthen the understanding of decision-making process; improve communication in the process of report writing with policy makers; and make the appropriate adjustments of language expression and processing when presenting the findings to make it easier to understand for policy makers, and thereby increase the likelihood of the knowledge translation. On the other hand, health technology assessment research institutions should take on the responsibility of training to improve the quality of Chinese health technology assessment study in the whole, so that policy makers will trust the results of health technology assessment.2. To establish necessary specifications or guidelines of health technology assessment studiesThere are many research institutions and researchers engaged in health technology assessment study, but they have different frameworks and methods. Overall, health technology assessment study in China still lacks certain norms. The quality of research results varied. Some studies could not be the evidence, and some studies could even mislead decisions. Therefore, it is necessary to establish health technology assessment study specifications or guidelines to enable that the overall quality of health technology research in China could be improved.3. To improve health technology assessment research systemsIt’s necessary to establish health technology assessment system to provide adequate financial support, qualified authentication for researchers, regular health assessment study training and knowledge translation training. Therefore, research funding, quality of researchers, and study quality can be guaranteed, unified and stable. In addition, specialized personnel and funding should be guaranteed to strengthen the dissemination of health technology assessment.