Journal
INTERNATIONAL JOURNAL OF TECHNOLOGY ASSESSMENT IN HEALTH CARE
Volume 36, Issue 6, Pages 592-598Publisher
CAMBRIDGE UNIV PRESS
DOI: 10.1017/S0266462320000537
Keywords
Public involvement; Health technology assessment; Soft systems methodology; Complex adaptive system; Focus groups
Categories
Funding
- Australian Department of Education and Training
- University of Adelaide
- University of Alberta
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Background Worldwide, governments employ health technology assessment (HTA) in healthcare funding decision making. Requests to include public perspectives in this are increasing, with the idea being that the public can identify social values to guide policy development, increasing the transparency and accountability of government decision making. Objective To understand the perspectives of the Canadian public on the rationale and design of public involvement in HTA. Design A demographically representative sample of residents of a Canadian province was selected to take part in two sets of two focus groups (sixteen people for the first set and twenty for the second set). Results Participants were suspicious of the interests driving various stakeholders involved in HTA. They saw the public as uniquely impartial though also lacking knowledge about health technologies. Participants were also suspicious of personal biases and commended mechanisms to reduce their impact. Participants suggested various involvement methods, such as focus groups, citizens' juries and surveys, noting advantages and disadvantages belonging to each and commending a combination. Discussion and conclusions We identified a lack of public understanding of how decisions are made and distrust concerning whose interests and values are being considered. Public involvement was seen as a way of providing information to the public and ascertaining their views and values. Participants suggested that public involvement should employ a mixed-methods strategy to support informed debate and participation of a large number of people.
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