{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T07:53:47Z","timestamp":1791359627672,"version":"4.3.1"},"reference-count":12,"publisher":"Aboutscience Srl","issue":"1","license":[{"start":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T00:00:00Z","timestamp":1791244800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Grhta"],"abstract":"<jats:p>Introduction: Hospital-based Health Technology Assessment (HTA) supports transparent decisions about adopting medical technologies by balancing practical benefits against clinical, organizational, and economic consequences. This study evaluated a single-use continence care system using an integrated decision-support framework.Methods: The single-use system, based on disposable absorbent components, was compared with the standard reusable bedpan\/urinal pathway, including washing and reprocessing. The assessment combined Multi-Criteria Decision Analysis (MCDA), Budget Impact Analysis (BIA), Cost-Consequence Analysis (CCA), a 30-day field test across inpatient units at two hospital sites, and an implementation-specific questionnaire. During the field test, 168 admissions were recorded. MCDA used a weighted aggregate score, while the economic analysis adopted the hospital perspective over three years. Deterministic sensitivity analyses examined economic inputs and MCDA domain weights.Results: The single-use system offered perceived advantages in ease of use, hygiene, and odor reduction. However, these did not offset limited supporting evidence, lower patient-comfort ratings, operational issues, and higher costs. The MCDA score decreased from 4.80 for standard care to 2.60 for the single-use system (difference: \u22122.20). Cost per patient increased from \u20ac0.65 to \u20ac1.00, an incremental cost of \u20ac0.35. The three-year budget impact was \u20ac2,634 and remained within the local affordability threshold. As the technology was more costly and produced lower overall MCDA value, it was classified as dominated. Sensitivity analyses did not alter the recommendation.Conclusion: The integrated MCDA-economic framework supported transparent hospital-level decision-making. Affordability and perceived practical advantages were insufficient to justify routine adoption of the single-use continence care system.<\/jats:p>","DOI":"10.33393\/grhta.2026.3828","type":"journal-article","created":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T07:41:15Z","timestamp":1791358875000},"page":"230-240","source":"Crossref","is-referenced-by-count":0,"title":["Real-world application of an integrated MCDA\u2013economic framework in continence care technology: a hospital-based case study"],"prefix":"10.33393","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-3804-3556","authenticated-orcid":false,"given":"Gianpaolo","family":"Franzoso","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-5425-8539","authenticated-orcid":false,"given":"Novella","family":"Piazzetta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2528-691X","authenticated-orcid":false,"given":"Giorgia","family":"Zorzetto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mirsad","family":"Pasalic","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentina","family":"Ceron","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-3229-953X","authenticated-orcid":false,"given":"Flavia","family":"Damiano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Tridello","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marina","family":"Coppola","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"18642","published-online":{"date-parts":[[2026,10,6]]},"reference":[{"key":"21092","doi-asserted-by":"crossref","unstructured":"Ferrante di Ruffano L, Harris IM, Zhelev Z, et al. Health technology assessment of diagnostic tests: a state of the art review of methods guidance from international organizations. Int J Technol Assess Health Care. 2023;39(1):e14. https:\/\/doi.org\/10.1017\/S0266462323000065 PMID:36803886","DOI":"10.1017\/S0266462323000065"},{"key":"21093","unstructured":"European Parliament and Council of the European Union. Regulation (EU) 2021\/2282 of December 15, 2021 on health technology assessment and amending Directive 2011\/24\/EU. Official Journal of the European Union. 2021;L458:1-32. Available from: https:\/\/eur-lex.europa.eu\/eli\/reg\/2021\/2282\/oj (Accessed May 2026)"},{"key":"21094","unstructured":"European Commission. Implementation of the Regulation on health technology assessment. Brussels: European Commission; Available from: https:\/\/health.ec.europa.eu\/health-technology-assessment\/implementation-regulation-health-technology-assessment_en [accessed 28 September 2026]. (Accessed May 2026)"},{"key":"21095","unstructured":"EUnetHTA Joint Action 2. HTA Core Model\u00ae version 3.0. 2016. Available from: https:\/\/www.htacoremodel.info\/model\/HTACoreModel3.0.pdf (Accessed May 2026)"},{"key":"21096","unstructured":"Agenzia Nazionale per i Servizi Sanitari Regionali (AGENAS). Programma Nazionale HTA Dispositivi Medici 2023-2025. AGENAS; 2024."},{"key":"21097","doi-asserted-by":"crossref","unstructured":"Sampietro-Colom L, Morilla-Bachs I, Gutierrez-Moreno S, et al. Development and test of a decision support tool for hospital health technology assessment. Int J Technol Assess Health Care. 2012;28(4):460-465. https:\/\/doi.org\/10.1017\/S0266462312000487 PMID:23062518","DOI":"10.1017\/S0266462312000487"},{"key":"21098","doi-asserted-by":"crossref","unstructured":"Thokala P, Devlin N, Marsh K, et al. Multiple criteria decision analysis for health care decision making\u2014an introduction: report 1 of the ISPOR MCDA emerging good practices task force. Value Health. 2016;19(1):1-13. https:\/\/doi.org\/10.1016\/j.jval.2015.12.003 PMID:26797229","DOI":"10.1016\/j.jval.2015.12.003"},{"key":"21099","doi-asserted-by":"crossref","unstructured":"Marsh K, IJzerman M, Thokala P, et al.; ISPOR Task Force. Multiple criteria decision analysis for health care decision making\u2014emerging good practices: report 2 of the ISPOR MCDA emerging good practices task force. Value Health. 2016;19(2):125-137. https:\/\/doi.org\/10.1016\/j.jval.2015.12.016 PMID:27021745","DOI":"10.1016\/j.jval.2015.12.016"},{"key":"21100","doi-asserted-by":"crossref","unstructured":"Sullivan SD, Mauskopf JA, Augustovski F, et al. Budget impact analysis-principles of good practice: report of the ISPOR 2012 Budget Impact Analysis Good Practice II Task Force. Value Health. 2014;17(1):5-14. https:\/\/doi.org\/10.1016\/j.jval.2013.08.2291 PMID:24438712","DOI":"10.1016\/j.jval.2013.08.2291"},{"key":"21101","unstructured":"Drummond MF, Sculpher MJ, Claxton K, et al. Methods for the Economic Evaluation of Health Care Programmes. 4th ed. Oxford University Press; 2015."},{"key":"21102","doi-asserted-by":"crossref","unstructured":"Martin J, Lal A, Moodie J, et al. Hospital-Based HTA and Know4Go at MEDICI in London, Ontario, Canada. In: Sampietro-Colom L, Martin J, eds. Hospital-Based Health Technology Assessment: The Next Frontier for Health Technology Assessment. Springer; 2016:127-152, https:\/\/doi.org\/10.1007\/978-3-319-39205-9_12.","DOI":"10.1007\/978-3-319-39205-9_12"},{"key":"21103","doi-asserted-by":"crossref","unstructured":"Ruggeri M, Cadeddu C, Roazzi P, et al. Multi-Criteria-Decision-Analysis (MCDA) for the horizon scanning of health innovations an application to COVID 19 emergency. Int J Environ Res Public Health. 2020;17(21):7823. https:\/\/doi.org\/10.3390\/ijerph17217823 PMID:33114587","DOI":"10.3390\/ijerph17217823"}],"container-title":["Global and Regional Health Technology Assessment"],"original-title":[],"link":[{"URL":"https:\/\/journals.aboutscience.eu\/index.php\/grhta\/article\/download\/3828\/5355","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.aboutscience.eu\/index.php\/grhta\/article\/download\/3828\/5356","content-type":"application\/epub+zip","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.aboutscience.eu\/index.php\/grhta\/article\/download\/3828\/5355","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T07:41:27Z","timestamp":1791358887000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.aboutscience.eu\/index.php\/grhta\/article\/view\/3828"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,6]]},"references-count":12,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,7,15]]}},"URL":"https:\/\/doi.org\/10.33393\/grhta.2026.3828","relation":{},"ISSN":["2283-5733","2284-2403"],"issn-type":[{"value":"2283-5733","type":"electronic"},{"value":"2284-2403","type":"print"}],"subject":[],"published":{"date-parts":[[2026,10,6]]}}}