EUnetHTA Adaptation Glossary (beta)

Setting

In general “Setting” seems to be understood as the place where something occurs. The “setting” for example is the where a technology is implemented.
There seems to be some confusion for this term since sometimes it seems to be a geographical concept (national setting, regional setting, local setting), sometimes seems to be a concept referred to the type of health system (NHS-setting, SHI-setting) and sometimes a concept related to the type of care or institution (ambulatory setting, hospital setting, academic setting).

Context applies to the local setting in which the output of the HTA-process should apply, and may be viewed as the brokering of science into decision-making processes. In this process issues to consider are the facilitators or restrictions for applying the HTA-conclusions into the local setting. These issues are financial restrictions/facilitators, organisational issues such as hospital structure, education, speciality services, legal issues such as patients access to treatment.

Context: The conditions and circumstances that are relevant to the application of an intervention, for example the setting [in hospital, at home, in the air], the time [working day, holiday, night-time], type of practice [primary, secondary, tertiary care; private practice, insurance practice, charity], whether routine or emergency.

Context and setting both refer to the place and time from which the evidence for the HTA report has come and/or in which the HTA report will be used. Time and place are both important dimensions of context/setting, as are level (national, regional, local), the kind of decision being made.

‘Setting’ in particular is commonly used in HTA to refer narrowly to an organizational dimension of health care, such as primary, secondary or tertiary care, or community care.