Anticipating and Assessing Health Care Technology

This report, Anticipating and Assessing Health Care Technology, is the first report from the STG Commission on Future Health Care Technology. The STG (Stuurgroep Toekomstscenario's Gezondheidzorg) was established in 1983 as an independent advisory group to the State Secretary for Welfare, Public Health, and Cultural Affairs (WVC) to assist in long-range health planning efforts. Thus far, STG commissions have examined cardiovascular disease, cancer, aging, and life styles as issues of importance to the health of the Dutch population in the future. Obviously, health care technology is of great concern to the government. On the one hand, technology is one of the major tools to promote a healthy population. On the other hand, the costs of health care have been rising at an alarming rate in recent years. It was these two facts, along with the social consequences of certain technologies such as genetic screening, that led the STG to establish the Commission on Future Health Care Technology in 1985. The European Office of the World Health Organization (EURO) cosponsored the project. The Health Council (Gezondheidsraad) agreed to cooperate with the project by furnishing space and intellectual and logistical support. The goal of the Commission's work is to develop sufficient information on future technological developments in health and health care to assist planning for their consequences. Subsequent reports will give more detail on future health care technologies and will provide in-depth assessments on a few specific technological areas.

Inhalt

and Summary.- What is Technology Assessment?.- Diffusion of Health Care Technology.- Identifying Future Health Care Technology.- A System for Health Care Technology Assessment.- International Implications.- Policy Conclusions.- Organization of This Report.- I - Technological Change in Health Care and Its Implications for Society.- The Role of Technology in Society.- A Definition of Health Care Technology.- The Concept of Health.- Historical Perspective on Health Care Technology and Its Implications.- Implications of Health Care Technology in the Present.- Future Perspective on Health Care Technology.- Conclusion.- II - Development and Diffusion of Health Care Technology.- Biomedical Research and Technology Development.- Diffusion of Health Care Technology.- Conclusion.- III - Identifying and Assessing Health Care Technology.- What is Technology Assessment?.- Using Technology Assessment in Policy Mechanisms.- Analysis of Future Health Care Technology.- A System for Identifying Future Health Care Technology.- Prospective Assessments of Health Care Technology.- A System for Assessing Health Care Technology.- Conclusion.- IV - Anticipated Changes in Health Care Technology.- Health Care Technology and Its Effects on Health.- Technological Areas of Importance.- 1. Disease Prevention and Health Promotion.- 2. Nutrition.- 3. Social Interventions.- 4. The Brain, Behavior, and Mental Health.- 5. Reproduction and Fetal and Child Health.- 6. Medical Imaging and Other Diagnostic Technologies.- 7. Biotechnology-Related Developments.- 8. Biologies and Pharmaceuticals.- 9. Blood Banking.- 10. Artificial and Transplanted Organs and Tissues.- 11. Laser Technology.- 12. Other Progress in Surgery-Related Technology.- 13. Other Therapeutic Advances.- 14. Oral Health.- 15. Alternative Therapy.- 16. The Computer: Clinical Applications.- 17. The Computer: Organizational and Analytical Applications.- 18. Basic and Applied Sciences.- Conclusion.- V - The Health Policy Structure of the Netherlands.- Policy Toward Research and Development.- Policy Toward Assessment of Health Care Technology.- Regulation of Drugs and Biologies for Efficacy and Safety.- Regulation and Evaluation of Medical Devices (Equipment).- Policies in the Health Care Delivery System.- Financing of Health Care.- Controls on Technology.- Quality Assurance.- Conclusion.- VI - The International Context for Health Care Technology.- An International Perspective on Health-Related Research.- The Multi-National Industry.- National Efforts in Technology Assessment.- International Efforts in Technology Assessment.- Conclusion.- VII - Policy Conclusions.- Conclusions.- Conclusion 1: A Permanent, Well-funded System for Technology Assessment in Health Care Should be Developed in the Netherlands.- The Role of Future Studies of Health Care Technology in a System for Health Care Technology Assessment.- Why Must a Sytem to Examine Future Technology be Part of an Overall System for Health Care Technology Assessment?.- Key Issues to be Addressed by a National Program for Health Care Technology Assessment.- Conclusion 2: Existing Policies Need to be Examined for their Effects on Health Care Technology Development and Use.- Conclusion 3: International Networks for the Collection and Exchange of Information from Health Care Technology Assessments are Needed.- A Strategic Approach to Developing a Technology Assessment System.- The Health Council.- TNO.- RIVM.- Sick Funds and Sick Funds Council.- Private Insurance Companies.- Hospitals and Universities, and the National Hospital Institute.- Physicians and Physician Associations.- Other Health Care Providers.- CBO.- Industry.- The General Public.- Appendixes.- A. Financial Costs of Health Care Technology.- B. Technological Forecasting.- C. Method of the Study.- D. Acknowledgements.- E. Glossary of Terms.- F. Glossary of Acronyms.- G. References.