医院卫生技术评估的应用机制与实施路径研究

促进医疗资源的合理配置是医疗费用不合理快速增长现状下的迫切需要，也是新医改背景下对医院控制费用、提高质量和科学管理等方面提出的更高现实要求。本研究以促进医疗资源的合理配置为基本出发点，以推进卫生技术评估在医院环境的应用和发展为目标，构建医院卫生技术评估（HB-HTA）的应用机制与实施路径。研究采用定性与定量相结合的实证研究方法，一方面在欧盟HB-HTA等理论框架的指导下，对已开展HB-HTA的医院进行现况调研与案例分析，通过因子分析和结构方程模型等方法深入挖掘应用HB-HTA的促进和阻碍因素以及之间的逻辑关系；另一方面结合当前的政策环境，在前述研究信息的基础上，提出HB-HTA的应用机制与实施路径。研究将丰富卫生技术评估在医院层面的学科发展，促进国家层面新医改措施的有效落实，对医疗资源的科学合理配置有积极意义，具有较强的实际应用价值。

Improving the rational allocation of medical resources is an urgent need under the status quo of the irrational and rapid growth of medical expenses, meanwhile, it is also a higher realistic requirement for hospitals in terms of expense control, quality improvement, and scientific management under the background of new healthcare system reform. This study aims at the rational allocation of medical resources and the application and development of health technology assessment in the hospital environment, in order to construct the application mechanism and implementation roadmap of hospital-based health technology assessment (HB-HTA). The study adopts a combination of qualitative and quantitative empirical research methods. On the one hand, under the guidance of the European Union’s and other theoretical frameworks of HB-HTA, the present situation of HB-HTA practices in hospitals will be researched by survey and case study. The contributing and obstacle factors of applying HB-HTA and their logical relationship will be deeply explored by factor analysis and structural equation model. On the other hand, according to the current policy environment of China, on the basis of the above research information, the study puts forward the application mechanism and the implementation roadmap of HB-HTA. The results will enrich the subject development of health technology assessment at the hospital level, and effectively promote the implementation of the new healthcare system reform measures at the national level. There also is a positive significance for the scientific and rational allocation of medical resources, with a strong practical application value.