METHODS: After the development of 12 hypotheses, a quantitative, cross-sectional, self-administered survey method was applied to collect data in 9 hospitals in Iran. After the collection of 382 usable questionnaires, the partial least square structural modeling was applied to examine the hypotheses and it was found that 11 hypotheses were empirically supported.
RESULTS: The results suggest that patients' trust in hospitals can significantly predict their perceived security but no significant associations were found between patients' physical protection mechanisms in the hospital and their perceived information security in a hospital. We also found that patients' perceptions about the physical protection mechanism of a hospital can significantly predict their trust in hospitals which is a novel finding by this research.
CONCLUSIONS: The findings imply that hospitals should formulate policies to improve patients' perception about such factors, which ultimately lead to their perceived security.
Methods: A hybrid fuzzy multiple-criteria decision-making (FMCDM) process, consisting of the Analytic Hierarchy Process (AHP) and fuzzy Technique for Order of Preference by Similarity to Ideal Solution (fuzzy TOPSIS) method, is structured to aggregate the different criteria and rank different ELV alternatives in this complicated evaluation. In order to use the most profound knowledge and judgment of a professional expert team, this qualitative assessment highlights the importance of supportive information.
Results: The results obtained indicate that experts have considered the country-specific information as a reliable reference in their decisions. Among different key evaluation criteria in effluent standard setting, the highest experts' priority is "Environmental protection". For both the conventional and toxic pollutants, the influence of all other criteria namely "Economic feasibility", "Technology viability" and "Institutional capacity", as constraining criteria in developing countries, have not reduced the responsibility towards the environmental objectives. In ELVs ranking, experts have made their decisions with respect to the specific characteristics of each pollutant and the existing capacities and constraints of the country, without emphasizing on any specific reference.
Conclusions: This systematic and transparent approach has resulted in defensible country-specific ELVs for the Iron and Steel industry, which can be developed for other sectors. As the main conclusion, this paper demonstrates that FMCDM is a robust tool for this comprehensive assessment especially regarding the data availability limitations in developing countries.
METHODS: We described the evolution of HTA program in Malaysia based on review of administrative data, publicly available information and quantitative description of impact evaluation.
RESULTS: Health Technology Assessment HTA was formalized in Malaysia in 1995 as a central structure within the Ministry of Health, Malaysia in 1995. Expansion of activities demonstrated over the years including Horizon Scanning of health technologies and implementation of evidence-based Clinical Practice Guidelines. Improvement on the processes in terms of types of report, quality, monitoring, and impact evaluation as well as accessibility was also carried out. Examples of impact/influence of the reports have also been demonstrated.
CONCLUSIONS: HTA program in Malaysia has evolved over the past decades. Its role in policy formulation and decision making of health technologies has become more significant over the years and is foreseen to be bigger in the future. As a trusted source of evidence, HTA in Malaysia will continue to strengthen the health system by advocating informed decision making and value-based medicine. As other countries in this region is trying to establish their own HTA processes and procedures, this review on the evolution of the HTA program in Malaysia might give some insights on developing a sustainable HTA program.