Assessing the impact of health technology assessment in the Netherlands

Copyright © Cambridge University Press 2008Objectives: Investments in health research should lead to improvements in health and health care. This is also the remit of the main HTA program in the Netherlands. The aims of this study were to assess whether the results of this program have led to such improvements and to analyze how best to assess the impact from health research.Methods: We assessed the impact of individual HTA projects by adapting the "payback framework" developed in the United Kingdom. We conducted dossier reviews and sent a survey to principal investigators of forty-three projects awarded between 2000 and 2003. We then provided an overview of documented output and outcome that was assessed by ten HTA experts using a scoring method. Finally, we conducted five case studies using information from additional dossier review and semistructured key informant interviews.Results: The findings confirm that the payback framework is a useful approach to assess the impact of HTA projects. We identified over 101 peer reviewed papers, more than twenty-five PhDs, citations of research in guidelines (six projects), and implementation of new treatment strategies (eleven projects). The case studies provided greater depth and understanding about the levels of impact that arise and why and how they have been achieved.Conclusions: It is generally too early to determine whether the HTA program led to actual changes in healthcare policy and practice. However, the results can be used as a baseline measurement for future evaluation and can help funding organizations or HTA agencies consider how to assess impact, possibly routinely. This, in turn, could help inform research strategies and justify expenditure for health research.This research is funded by ZonMw, the Netherlands organization for health research and development (project 945-15-001)

Evolution of the Dutch University Medical Centers: At the interface of the Health care and the Science systems

A traditional way of analyzing the healthcare system suggests that major change flows from governmental action and trickles to other organizations in the system. A complex adaptive system view suggests a more dynamic analysis in which bottom-up emergent events are as important as top-down steering attempts. We argue that the Dutch University Medical Centers are a prime example of organizations that co-evolve with changes in both the health care and the science system

Regional capacity to govern the energy transition: The case of two Dutch energy regions

In this paper we analyse how interactions between governing bodies influence Dutch energy regions’ capacity to govern the energy transition. We develop an analytical framework which draws on, and merges, two different theoretical perspectives: multi-level governance and capacities for transformative climate governance. We apply this framework in an exploratory case study of the Dutch energy regions Holland Rijnland and Noordoost Brabant. Results are primarily derived using a set of interviews and desk study. Aided by the framework, we find that, while the Regional Energy Strategy (RES) arrangement is clearly geared towards facilitating orchestration through coordination and exchange of ideas and standpoints, the current governance approach, is hindered by unclear and ambiguous roles and responsibilities, a referral back to and dependence on traditional hierarchical structures, and high transaction costs. These interactions negatively influence capacity development in the regional energy transition by complicating strategic alignment and the creation of opportunity contexts

Additional file 1: of Networks of entrepreneurs driving the Triple Helix: two cases of the Dutch energy system

Translation of the abstract into Arabic. (PDF 244 kb