Regulatory space and the contextual mediation of common functional pressures: Analyzing the factors that led to the German Efficiency Frontier approach
Abstract There are no automatic links between the functional advantages and pressures associated with delegation to independent agencies for Health Technology Assessment (HTA) and their emergence in national regulatory spaces. We argue that the rise of these organizations is mediated by contextual f...
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| Veröffentlicht in: | Health policy (Amsterdam) 2013-03, Vol.109 (3), p.270-280 |
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| creator | Klingler, Corinna Shah, Sara M.B Barron, Anthony J.G Wright, John S.F |
| description | Abstract There are no automatic links between the functional advantages and pressures associated with delegation to independent agencies for Health Technology Assessment (HTA) and their emergence in national regulatory spaces. We argue that the rise of these organizations is mediated by contextual factors, which must be explained. Accordingly, we analyze the German ‘regulatory space’ for health policy decision-making, identifying contextual factors relevant to the adoption of the Efficiency Frontier approach. Based on qualitative interviews with key stakeholders, we argue that the development of the Efficiency Frontier can be associated with cultural reluctance to frame healthcare prioritization decisions around cost based valuations of human health and related doubts about the validity of metrics for human health gain. Based on this finding, we conclude that the delegation of authority to independent HTA agencies follows a broadly evolutionary pattern, in which contextual factors allow for significant variation in institutional and methodological responses to the functional pressures and advantages leading to their establishment. |
| doi_str_mv | 10.1016/j.healthpol.2013.01.004 |
| format | Article |
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We argue that the rise of these organizations is mediated by contextual factors, which must be explained. Accordingly, we analyze the German ‘regulatory space’ for health policy decision-making, identifying contextual factors relevant to the adoption of the Efficiency Frontier approach. Based on qualitative interviews with key stakeholders, we argue that the development of the Efficiency Frontier can be associated with cultural reluctance to frame healthcare prioritization decisions around cost based valuations of human health and related doubts about the validity of metrics for human health gain. Based on this finding, we conclude that the delegation of authority to independent HTA agencies follows a broadly evolutionary pattern, in which contextual factors allow for significant variation in institutional and methodological responses to the functional pressures and advantages leading to their establishment.</description><identifier>ISSN: 0168-8510</identifier><identifier>EISSN: 1872-6054</identifier><identifier>DOI: 10.1016/j.healthpol.2013.01.004</identifier><identifier>PMID: 23380191</identifier><language>eng</language><publisher>Amsterdam: Elsevier Ireland Ltd</publisher><subject>Biological and medical sciences ; Contextual factors ; Cost ; Cost-Benefit Analysis ; Decision-making ; Delegation ; Delegation of authority ; Efficiency frontier ; Efficiency, Organizational ; Germany ; Government Regulation ; Health ; Health administration ; Health care ; Health economics ; Health gain ; Health Policy ; Health technology assessment ; Humans ; Internal Medicine ; Mediation ; Medical sciences ; Methods ; Miscellaneous ; National Health Programs ; Public health. Hygiene ; Public health. Hygiene-occupational medicine ; Qualitative Research ; Regulation ; Regulatory space ; Technology ; Technology assessment ; Technology Assessment, Biomedical - economics ; Valuation</subject><ispartof>Health policy (Amsterdam), 2013-03, Vol.109 (3), p.270-280</ispartof><rights>Elsevier Ireland Ltd</rights><rights>2013 Elsevier Ireland Ltd</rights><rights>2014 INIST-CNRS</rights><rights>Copyright © 2013 Elsevier Ireland Ltd. 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We argue that the rise of these organizations is mediated by contextual factors, which must be explained. Accordingly, we analyze the German ‘regulatory space’ for health policy decision-making, identifying contextual factors relevant to the adoption of the Efficiency Frontier approach. Based on qualitative interviews with key stakeholders, we argue that the development of the Efficiency Frontier can be associated with cultural reluctance to frame healthcare prioritization decisions around cost based valuations of human health and related doubts about the validity of metrics for human health gain. Based on this finding, we conclude that the delegation of authority to independent HTA agencies follows a broadly evolutionary pattern, in which contextual factors allow for significant variation in institutional and methodological responses to the functional pressures and advantages leading to their establishment.</description><subject>Biological and medical sciences</subject><subject>Contextual factors</subject><subject>Cost</subject><subject>Cost-Benefit Analysis</subject><subject>Decision-making</subject><subject>Delegation</subject><subject>Delegation of authority</subject><subject>Efficiency frontier</subject><subject>Efficiency, Organizational</subject><subject>Germany</subject><subject>Government Regulation</subject><subject>Health</subject><subject>Health administration</subject><subject>Health care</subject><subject>Health economics</subject><subject>Health gain</subject><subject>Health Policy</subject><subject>Health technology assessment</subject><subject>Humans</subject><subject>Internal Medicine</subject><subject>Mediation</subject><subject>Medical sciences</subject><subject>Methods</subject><subject>Miscellaneous</subject><subject>National Health Programs</subject><subject>Public health. Hygiene</subject><subject>Public health. Hygiene-occupational medicine</subject><subject>Qualitative Research</subject><subject>Regulation</subject><subject>Regulatory space</subject><subject>Technology</subject><subject>Technology assessment</subject><subject>Technology Assessment, Biomedical - economics</subject><subject>Valuation</subject><issn>0168-8510</issn><issn>1872-6054</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>7QJ</sourceid><sourceid>7TQ</sourceid><recordid>eNqNks2O0zAQgCMEYrsLrwC-IHFp8X9SDkjVandBWgmJn7PluOOtSxIHO0GUF9nXZdKWReJCL4k9-TwzznxF8ZLRBaNMv9kuNmCbYdPHZsEpEwvKFpTKR8WMVSWfa6rk42KGZDWvFKNnxXnOW0ppKYR-WpxxISrKlmxW3H-Cu7GxQ0w7knvrgNhuTYYNEBe7AX4Oo21IC-tghxA7Ej3G2xZXfuzcFMLPfYKcR3y8JSvc736F7m6fwluHiTOu7UAawLxxH7-B1NqOXHkfXIDO7ch1wmoBErF9n6J1m2fFE2-bDM-P74vi6_XVl8v389uPNx8uV7dzp5Qa5q4u114sgStdKidtVa9rScHapVZaUMedF7LijFZWspo7JX1la1FXopSM49-4KF4f8mLZ7yPkwbQhO2ga20Ecs2GiFFLrif0_qmWplZKnoLykGps4pQHGK7HkfELLA-pSzDmBN30KrU07w6iZtDBb86CFmbQwlBnUAk--OBYZaxzmw7k_HiDw6gjY7Gzjk-1cyH-5Ei-HnSC3OnCAM_mBAzN5P0EUJIEbzDqGE5p5908O14QuYNlvsIO8jWNCi_DmJnNDzefJ4kliJlBgJrX4DbnA8B0</recordid><startdate>20130301</startdate><enddate>20130301</enddate><creator>Klingler, Corinna</creator><creator>Shah, Sara M.B</creator><creator>Barron, Anthony J.G</creator><creator>Wright, John S.F</creator><general>Elsevier Ireland Ltd</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>8BJ</scope><scope>FQK</scope><scope>JBE</scope><scope>7QJ</scope><scope>7TQ</scope><scope>DHY</scope><scope>DON</scope></search><sort><creationdate>20130301</creationdate><title>Regulatory space and the contextual mediation of common functional pressures: Analyzing the factors that led to the German Efficiency Frontier approach</title><author>Klingler, Corinna ; Shah, Sara M.B ; Barron, Anthony J.G ; Wright, John S.F</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c555t-cb7df39e25675c4a8bdb40eaa965630c2cf3482108a41b2c54f8ab3b837412733</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Biological and medical sciences</topic><topic>Contextual factors</topic><topic>Cost</topic><topic>Cost-Benefit Analysis</topic><topic>Decision-making</topic><topic>Delegation</topic><topic>Delegation of authority</topic><topic>Efficiency frontier</topic><topic>Efficiency, Organizational</topic><topic>Germany</topic><topic>Government Regulation</topic><topic>Health</topic><topic>Health administration</topic><topic>Health care</topic><topic>Health economics</topic><topic>Health gain</topic><topic>Health Policy</topic><topic>Health technology assessment</topic><topic>Humans</topic><topic>Internal Medicine</topic><topic>Mediation</topic><topic>Medical sciences</topic><topic>Methods</topic><topic>Miscellaneous</topic><topic>National Health Programs</topic><topic>Public health. Hygiene</topic><topic>Public health. Hygiene-occupational medicine</topic><topic>Qualitative Research</topic><topic>Regulation</topic><topic>Regulatory space</topic><topic>Technology</topic><topic>Technology assessment</topic><topic>Technology Assessment, Biomedical - economics</topic><topic>Valuation</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Klingler, Corinna</creatorcontrib><creatorcontrib>Shah, Sara M.B</creatorcontrib><creatorcontrib>Barron, Anthony J.G</creatorcontrib><creatorcontrib>Wright, John S.F</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>International Bibliography of the Social Sciences (IBSS)</collection><collection>International Bibliography of the Social Sciences</collection><collection>International Bibliography of the Social Sciences</collection><collection>Applied Social Sciences Index & Abstracts (ASSIA)</collection><collection>PAIS Index</collection><collection>PAIS International</collection><collection>PAIS International (Ovid)</collection><jtitle>Health policy (Amsterdam)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Klingler, Corinna</au><au>Shah, Sara M.B</au><au>Barron, Anthony J.G</au><au>Wright, John S.F</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Regulatory space and the contextual mediation of common functional pressures: Analyzing the factors that led to the German Efficiency Frontier approach</atitle><jtitle>Health policy (Amsterdam)</jtitle><addtitle>Health Policy</addtitle><date>2013-03-01</date><risdate>2013</risdate><volume>109</volume><issue>3</issue><spage>270</spage><epage>280</epage><pages>270-280</pages><issn>0168-8510</issn><eissn>1872-6054</eissn><abstract>Abstract There are no automatic links between the functional advantages and pressures associated with delegation to independent agencies for Health Technology Assessment (HTA) and their emergence in national regulatory spaces. 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| ispartof | Health policy (Amsterdam), 2013-03, Vol.109 (3), p.270-280 |
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| source | Applied Social Sciences Index & Abstracts (ASSIA); MEDLINE; PAIS Index; Elsevier ScienceDirect Journals |
| subjects | Biological and medical sciences Contextual factors Cost Cost-Benefit Analysis Decision-making Delegation Delegation of authority Efficiency frontier Efficiency, Organizational Germany Government Regulation Health Health administration Health care Health economics Health gain Health Policy Health technology assessment Humans Internal Medicine Mediation Medical sciences Methods Miscellaneous National Health Programs Public health. Hygiene Public health. Hygiene-occupational medicine Qualitative Research Regulation Regulatory space Technology Technology assessment Technology Assessment, Biomedical - economics Valuation |
| title | Regulatory space and the contextual mediation of common functional pressures: Analyzing the factors that led to the German Efficiency Frontier approach |
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