This project has received funding from the European Union’s Horizon 2020 research and innovation programme under grant agreement No 779312


Analysis of economic evaluation methods for hospital-based assessment

  • To outline improved methods for measuring performance in secondary care settings, which are central to hospital quality improvement, linking performance measurement with related organizational models

  • To identify which and to which extent organizational/contextual factors impact the benefit generated by health technologies

  • To produce a standardized method to measure the clinical variability with respect to the different organizational models in secondary care settings based on evidence from a selection of therapeutic areas

  • Based on a prior extensive literature review, multiple case studies and quantitative methods (e.g. regression analysis) will be applied to identify a minimum set of indicators capturing variability in hospital performance

  • A pilot study involving a network of collaborating hospitals will validate the methodology and the tool developed through a multiple case study approach

  • Based on this, and building on AdHopHTA (, a standard approach to assess organizational factors affecting health technologies’ effectiveness and the subsequent variability in the cost of care will be inferred

  • Literature research and analysis on relationship between clinical decision making and organizational factors

  • Analysis of two case studies: (1) Diagnostic use of high sensitivity troponin and its impact on NSTEMI myocardial infarction (Non-ST elevation myocardial infarction) diagnosis and treatment; (2) Use of robotic surgery with Da Vinci Robot

  • Toolkit including a list of relevant indicators to capture hospital performance variability and standard methodology to identify key organizational variables responsible for hospital performance

  • Toolkit to assess the transferability of evidence produced in other jurisdictions and decision-making levels

  • Toolkit to identify the clinical variability and its impact on the use of health technology compared to purely organizational variables, which will include a checklist to appraise the variability and a projection model on clinical outcomes

Research Update

January 2019 – IMPACT HTA 2nd Project Meeting (Presentation PDF)

January 2020 – IMPACT HTA 3rd Project Meeting (Presentation PPT)


Università Cattolica del Sacro Cuore


Istituto Superiore di Sanita 

Principal Investigators

Americo Cicchetti

Marco Marchetti