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Table 1 Category system created for the focus group analysis and n of codes, n of coded citations within the qualitative content analysis

From: Reimbursement decisions for medical services in Austria: an analysis of influencing factors for the hospital individual services catalogue between 2008 and 2020

Aspect (Code-Group)

Inductive or deductive

Source

Description

N of codes

N of coded citations in focus group

Clinical evidence (EFF/SAF)

Deductive

[21]

This aspect covers whether a new hospital medical service is more effective (EFF) and at least as safe (SAF) as the comparator

1

1

Costs

Deductive and inductive

[21]

This domain was broad and covers not only comparative economic evaluations as defined in the EUnetHTA Core Model, but also whether the cost of the new EMS played some sort of a role in the decision making process

1

1

ORG/ quality assurance

Deductive and inductive

[21]

“The domain of Organisational Aspects (ORG) considers the ways in which different kinds of resources (e.g. material artefacts, human skills and knowledge, money, attitudes, work culture) need to be mobilised and organised when implementing a technology, and the consequences they may further on produce in the organisation and the health care system as a whole. Organisational issues include e.g. work processes and patient/participant flow, quality and sustainability assurance, centralisation, communication and co-operation, managerial structure, and acceptance of a technology.”

Within this domain, especial focus was attributed to quality assurance. We linked the broad term quality assurance with ORG after noting that there is considerable overlap

5

16

ETH/SOC

Deductive

[21]

“The Ethical Analysis (ETH) domain considers prevalent social and moral norms and values relevant to the technology in question. It involves an understanding of the consequences of implementing or not implementing a healthcare technology in two respects: with regard to the prevailing societal values and with regard to the norms and values that the technology itself constructs when it is put into use “

“The Patients and Social Aspects (SOC) domain takes patients or individuals in whose care a health technology is used as a point of reference in an HTA. Patients Aspects relate to issues relevant to patients, individuals and caregivers. Patient refers to a person who receives (or has received) and uses (or used) health technologies and health services in the healthcare sector. The term individual is sometimes used synonymously with ‘patient’, but it can also refer to a healthy individual, who receives health technologies, e.g. a person taking part in a screening programme. The term caregivers (sometimes referred to as carers) refers to family, friends and other persons from the patient’s/individual’s social network, who provide care to the patient and are in other ways involved during the course of the disease. It excludes those paid to give care, such as healthcare professionals. Social Aspects are related to social groups, that is specific groupings of patients or individuals that may be of specific interest in an HTA, such as older people, people living in remote communities, people with learning disabilities, ethnic minorities, immigrants etc.”

1

1

REG

Deductive

[21]

Regulatory aspects (REG) are covered within the TEC/ description and technical characteristics of the technology EUnetHTA domain. The regulatory (REG) status addresses primarily whether (and for which indications) the technology received a marketing authorisation/ CE marking

0

0

Situational Aspect

Inductive

Self-defined

These aspects were defined as a set of (external) circumstances that may have influenced a reimbursement decision at a given time

1

4

Other countries

Inductive

Self-defined

The aspect “other countries” covers the potential influence of prior reimbursement coverage decisions of certain technologies from other countries

2

3

LEG

Deductive

[21]

“The objective of the Legal Aspects (LEG) domain is to assist the HTA doers in detecting rules and regulations which need to be taken into consideration when evaluating the implications and consequences of implementing a health technology. Rules and regulations have been established to protect the patient’s rights and societal interests. The rules and regulations may be a part of patient rights legislation, data protection legislation, or health care personnel’s provisions, rights and duties in general (…)”

0

0

Procedural aspects

Inductive

[15]

Procedural aspects are linked to the criteria used within the general reimbursement process of the LKF Model

9

14