Global & Regional Health Technology Assessment最新文献

[This corrects the article DOI: 10.33393/grhta.2026.3606.].

Introduction: The use of fibrobronchoscopy increased significantly for collecting airway microbiological samples and during percutaneous tracheostomies and difficult intubations. Reusable bronchoscopes pose risks of contamination and damage due to their fragile structure and difficulties of cleaning and sterilization; single-use bronchoscopes have been introduced, offering reliability in terms of vision, maneuverability, suctioning capacity, and sterility, reducing the risk of hospital-acquired infections and improving logistical management.

Methods: The study analyzed healthcare workers' and management's perceptions of single-use bronchoscopes versus reusable ones. Among the main objectives were to evaluate the organizational impact, quality, and performance of bronchoscopes, while also analyzing opinions on device features, safety in infection prevention, and ease of use during training.

Results: In this analysis 66% of clinicians rated optimal image quality, and 90% of respondents highly appreciated the "plug & play" feature of disposable endoscopes; also, 45% of clinicians noted no significant differences in aspiration performance. Healthcare professionals felt more exposed to infectious agents with reusable endoscopes, believing disposable endoscopes required less vigilance and monitoring. In training, 80% of doctors and 100% of nurses considered disposable endoscopes more suitable due to their greater ease of use. Finally, the Overall Satisfaction of all healthcare workers was 75%.

Conclusion: The analysis of results demonstrated that the use of single-use bronchoscopes in anesthesia and resuscitation is highly comparable in terms of clinical effectiveness to reusable ones and that significant advantages in costs and organizational impact were highlighted, positively impacting the daily workflow of healthcare workers.

Introduction: Automated unit-dose (UD) medication distribution systems are increasingly recognized as enabling technologies for safer, more efficient, and traceable drug administration in hospitals. Closed-loop UD systems integrate electronic prescribing, automated dispensing, and bedside barcode scanning to ensure full traceability throughout the medication process. This study evaluated the clinical effectiveness, organizational impact, and cost-effectiveness of a closed-loop UD system implemented at a 930-bed national referral hospital in Northern Italy, compared with the previous ward-stock system.

Methods: A convergent mixed-methods mini-Health Technology Assessment combined administrative, clinical, and financial data (2018-2021) with literature evidence and 18 semi-structured staff interviews. Outcomes included medication administration errors (MAEs), adverse drug reactions (ADRs), and preventable hospitalizations. Cost-effectiveness was assessed from the Italian National Health Service perspective, and qualitative findings were analyzed using framework analysis.

Results: Based on literature-derived parameters, the model suggests a reduction in MAE rate from 10.6% to 5.0%, preventing an estimated 57,247 errors, 4,294 ADRs, and 42 hospitalizations per year. These outcomes were associated with net annual savings of €1.32 million and an ICER of €48.67 per error avoided. The model also indicated that around 34,000 nursing hours could be reallocated to direct patient care, while qualitative evidence highlighted improved staff satisfaction and medication traceability. Sensitivity analyses confirmed economic robustness in 95% of simulations.

Conclusions: Implementation of a closed-loop UD system enhances medication safety, workflow efficiency, and cost-effectiveness, supporting its scalability as a strategic innovation aligned with institutional goals for quality and sustainability.

Scientific and technological advances have increased the capacity to prevent diseases, perform diagnoses, and develop innovative treatments. To analyze whether these technologies should be incorporated into healthcare systems, Health Technology Assessment (HTA) Committees were created. There is a debate about who should be part of such committees. Typically, committee members are scientific experts, agents of funding entities (Ministries of Health), and patients as representatives of the community. It is important to reflect on the conflicts of interest that each member may have. Those who come from the scientific sector (universities, research centers) have fewer conflicts of interest and more independence for decision-making. The agents designated as members by the Ministries of Health of each country are usually qualified professionals, but still employees of those who will later have to pay for the technology. The third type of members are patients representing the community. This participation is considered a guarantee of neutrality, however, since patients are affected by the same health problem that is being analyzed, it exists a personal interest in expecting that a new medicine could be accepted to benefit other patients with the same condition (horizontal equity); with a potential risk of not showing the same empathy in recognizing the impact of this decision on other health problems (vertical equity). This text discusses the composition of HTA Committees, the conflicts of interest of its members, and the potential impact of these decisions on equity in access to the population to essential goods.