La introducción de tecnologías en los sistemas sanitarios: del dicho al hecho
The introduction of technologies in health care systems: from saying to doing
Anna García-Altés
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annagarcia@post.harvard.edu
Correspondencia: Fundación Instituto de Investigación en Servicios de Salud.
Correspondencia: Fundación Instituto de Investigación en Servicios de Salud.
Fundación Instituto de Investigación en Servicios de Salud. Agència de Salut Pública de Barcelona. Barcelona. España
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Agència de Salut Pública de Barcelona. Barcelona. España</span>" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "*" "correspondencia" => "Correspondencia: Fundación Instituto de Investigación en Servicios de Salud." ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "The introduction of technologies in health care systems: from saying to doing" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2004-01-30" "fechaAceptado" => "2004-04-16" "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "<span class="elsevierStyleBold">Palabras clave</span>" "identificador" => "xpalclavsec268595" "palabras" => array:4 [ 0 => "Evaluación de tecnologías" 1 => "Política sanitaria" 2 => "Medicina basada en la evidencia" 3 => "Asignación de recursos" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "<span class="elsevierStyleBold">Key words</span>" "identificador" => "xpalclavsec268596" "palabras" => array:4 [ 0 => "Technology assessment" 1 => "Health policy" 2 => "Evidence-based medicine" 3 => "Resource allocation" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<span class="elsevierStyleSectionTitle">Introducción</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">La evaluación de tecnologías sanitarias (ETS) es un instrumento basado en la evidencia científica para la toma de decisiones sobre la inclusión de avances tecnológicos en los sistemas sanitarios. Ahora bien, hay múltiples condicionantes y elementos, provenientes tanto de la propia ETS como de profesionales, políticos y de la sociedad, que influyen en que los resultados de la ETS se lleven a cabo. El objetivo de este artículo es describir los principales elementos que condicionan la aplicación de la ETS en la práctica y su uso en el ámbito clínico y en la política sanitaria.</p> <span class="elsevierStyleSectionTitle">Métodos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Se ha realizado una búsqueda bibliográfica en la base de datos biomédica PubMed. Se revisaron las referencias seleccionadas, así como la bibliografía adicional y la literatura gris identificada a partir de las referencias, que trataba de temas relacionados con la práctica de la ETS. Los resultados se presentan de manera descriptiva, haciendo un análisis de los estudios agrupados por los distintos aspectos de la ETS.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Algunos elementos clave en los que hay posibilidades de mejora son la estandarización del proceso de evaluación, la descripción de la misión de la organización, la priorización de tecnologías a evaluar, la claridad en la presentación de los resultados, la inclusión de valores sociales y de costeefectividad, y el aumento de la coordinación internacional.</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Para muchos, la razón de ser de la ETS es su función explícita en la toma de decisiones, aunque esto no está exento de problemas. Todo parece indicar que el futuro inmediato de la ETS pasa por explicitar los procesos de evaluación y la clara inclusión de la ETS en la toma de decisiones, con todo lo que ello supone de priorización de tecnologías, establecimiento de límites en cuanto al consumo de recursos económicos y vinculación con los procesos políticos.</p>" ] "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span class="elsevierStyleSectionTitle">Introduction</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Health technology assessment (HTA) is a tool based on scientific evidence useful for making decisions about the introduction of technological advances in healthcare systems. However, there are multiple elements that influence the actual use of the results of HTA. These elements are related both to the characteristics of HTA and to the stakeholders involved –health professionals, politicians, and society. The aim of this article was to describe the main elements that influence the applicability of HTA in practice, as well as the use of HTA in clinical practice and health policy.</p> <span class="elsevierStyleSectionTitle">Methods</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">A literature search was performed in PubMed. The references retrieved, as well as additional bibliography and gray literature dealing with different aspects of HTA practice identified from the references retrieved, were reviewed. The results are presented descriptively, with analysis of the studies grouped according to the various HTA-related topics.</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Key elements that could be improved are standardization of the evaluation process, description of the organization’s mission, prioritization of the technologies to be assessed, the clarity of the presentation of results, inclusion of values other than scientific evidence, such as social and costeffectiveness values, and increased international coordination.</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">For many people, the rationale for HTA is its explicit role in decision making, despite its problems. The immediate future of HTA would seem to include making the assessment process explicit, and the inclusion of HTA in decision making. This entails prioritization of technologies, setting limits on resource allocation and interrelation with political processes.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:68 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Conocimientos, valores y políticas en economía de la salud" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "J. Puig-Junoy" 1 => "V. Ortún" 2 => "S. 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| año/Mes | Html | Total | |
|---|---|---|---|
| 2024 Noviembre | 10 | 7 | 17 |
| 2024 Octubre | 96 | 42 | 138 |
| 2024 Septiembre | 82 | 15 | 97 |
| 2024 Agosto | 87 | 25 | 112 |
| 2024 Julio | 40 | 20 | 60 |
| 2024 Junio | 43 | 14 | 57 |
| 2024 Mayo | 44 | 20 | 64 |
| 2024 Abril | 46 | 15 | 61 |
| 2024 Marzo | 41 | 20 | 61 |
| 2024 Febrero | 48 | 48 | 96 |
| 2024 Enero | 31 | 17 | 48 |
| 2023 Diciembre | 40 | 18 | 58 |
| 2023 Noviembre | 38 | 18 | 56 |
| 2023 Octubre | 31 | 13 | 44 |
| 2023 Septiembre | 40 | 14 | 54 |
| 2023 Agosto | 41 | 17 | 58 |
| 2023 Julio | 43 | 16 | 59 |
| 2023 Junio | 62 | 13 | 75 |
| 2023 Mayo | 43 | 12 | 55 |
| 2023 Abril | 33 | 17 | 50 |
| 2023 Marzo | 42 | 33 | 75 |
| 2023 Febrero | 26 | 10 | 36 |
| 2023 Enero | 28 | 18 | 46 |
| 2022 Diciembre | 49 | 35 | 84 |
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| 2022 Octubre | 35 | 27 | 62 |
| 2022 Septiembre | 32 | 38 | 70 |
| 2022 Agosto | 38 | 52 | 90 |
| 2022 Julio | 36 | 37 | 73 |
| 2022 Junio | 26 | 36 | 62 |
| 2022 Mayo | 34 | 30 | 64 |
| 2022 Abril | 36 | 35 | 71 |
| 2022 Marzo | 39 | 36 | 75 |
| 2022 Febrero | 41 | 32 | 73 |
| 2022 Enero | 24 | 40 | 64 |
| 2021 Diciembre | 30 | 34 | 64 |
| 2021 Noviembre | 35 | 41 | 76 |
| 2021 Octubre | 29 | 45 | 74 |
| 2021 Septiembre | 35 | 44 | 79 |
| 2021 Agosto | 18 | 32 | 50 |
| 2021 Julio | 22 | 28 | 50 |
| 2021 Junio | 26 | 24 | 50 |
| 2021 Mayo | 29 | 26 | 55 |
| 2021 Abril | 119 | 22 | 141 |
| 2021 Marzo | 36 | 22 | 58 |
| 2021 Febrero | 27 | 12 | 39 |
| 2021 Enero | 23 | 14 | 37 |
| 2020 Diciembre | 30 | 13 | 43 |
| 2020 Noviembre | 9 | 5 | 14 |
| 2020 Octubre | 20 | 10 | 30 |
| 2020 Septiembre | 24 | 6 | 30 |
| 2020 Agosto | 14 | 11 | 25 |
| 2020 Julio | 19 | 13 | 32 |
| 2020 Junio | 21 | 9 | 30 |
| 2020 Mayo | 31 | 5 | 36 |
| 2020 Abril | 53 | 12 | 65 |
| 2020 Marzo | 11 | 3 | 14 |
| 2020 Febrero | 13 | 23 | 36 |
| 2020 Enero | 18 | 9 | 27 |
| 2019 Diciembre | 29 | 21 | 50 |
| 2019 Noviembre | 12 | 5 | 17 |
| 2019 Octubre | 27 | 12 | 39 |
| 2019 Septiembre | 8 | 1 | 9 |
| 2019 Agosto | 11 | 7 | 18 |
| 2019 Julio | 15 | 6 | 21 |
| 2019 Junio | 10 | 10 | 20 |
| 2019 Mayo | 17 | 10 | 27 |
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| 2019 Marzo | 9 | 20 | 29 |
| 2019 Febrero | 13 | 7 | 20 |
| 2019 Enero | 4 | 6 | 10 |
| 2018 Diciembre | 5 | 9 | 14 |
| 2018 Noviembre | 14 | 16 | 30 |
| 2018 Octubre | 18 | 26 | 44 |
| 2018 Septiembre | 18 | 10 | 28 |
| 2018 Agosto | 16 | 8 | 24 |
| 2018 Julio | 26 | 8 | 34 |
| 2018 Junio | 26 | 11 | 37 |
| 2018 Mayo | 19 | 7 | 26 |
| 2018 Abril | 21 | 7 | 28 |
| 2018 Marzo | 16 | 18 | 34 |
| 2018 Febrero | 10 | 4 | 14 |
| 2018 Enero | 5 | 6 | 11 |
| 2017 Diciembre | 14 | 9 | 23 |
| 2017 Noviembre | 12 | 9 | 21 |
| 2017 Octubre | 10 | 8 | 18 |
| 2017 Septiembre | 13 | 9 | 22 |
| 2017 Agosto | 8 | 9 | 17 |
| 2017 Julio | 17 | 9 | 26 |
| 2017 Junio | 35 | 12 | 47 |
| 2017 Mayo | 36 | 14 | 50 |
| 2017 Abril | 22 | 5 | 27 |
| 2017 Marzo | 14 | 6 | 20 |
| 2017 Febrero | 12 | 4 | 16 |
| 2017 Enero | 6 | 2 | 8 |
| 2016 Diciembre | 32 | 7 | 39 |
| 2016 Noviembre | 26 | 7 | 33 |
| 2016 Octubre | 25 | 7 | 32 |
| 2016 Septiembre | 22 | 6 | 28 |
| 2016 Agosto | 25 | 4 | 29 |
| 2016 Julio | 20 | 7 | 27 |
| 2015 Diciembre | 2 | 0 | 2 |
| 2015 Noviembre | 0 | 4 | 4 |
| 2015 Octubre | 1 | 8 | 9 |
| 2015 Septiembre | 1 | 11 | 12 |
| 2015 Agosto | 1 | 0 | 1 |
| 2015 Julio | 1 | 6 | 7 |
| 2015 Junio | 3 | 0 | 3 |
| 2015 Mayo | 1 | 0 | 1 |
| 2015 Abril | 1 | 3 | 4 |
| 2015 Marzo | 1 | 0 | 1 |
| 2015 Febrero | 4 | 2 | 6 |
| 2015 Enero | 4 | 1 | 5 |
| 2014 Diciembre | 5 | 1 | 6 |
| 2014 Noviembre | 5 | 1 | 6 |
| 2014 Octubre | 3 | 1 | 4 |
| 2014 Septiembre | 3 | 1 | 4 |
| 2014 Agosto | 13 | 1 | 14 |
| 2014 Julio | 10 | 2 | 12 |
| 2014 Junio | 12 | 1 | 13 |
| 2014 Mayo | 6 | 1 | 7 |
| 2014 Abril | 4 | 0 | 4 |
| 2014 Marzo | 5 | 0 | 5 |
| 2014 Febrero | 8 | 0 | 8 |
| 2014 Enero | 10 | 0 | 10 |
| 2013 Diciembre | 14 | 3 | 17 |
| 2013 Noviembre | 20 | 3 | 23 |
| 2013 Octubre | 24 | 2 | 26 |
| 2013 Septiembre | 13 | 3 | 16 |
| 2013 Agosto | 31 | 2 | 33 |
| 2013 Julio | 24 | 3 | 27 |
| 2004 Agosto | 1238 | 0 | 1238 |
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