This study aims to investigate the awareness, practices, needs, and challenges of hospital-based health technology assessment (HB-HTA) in China’s tertiary public hospitals, drawing on perspectives from both hospital management and clinical practice.

Semi-structured interviews were conducted with seventeen participants representing six major tertiary public hospitals in China. Respondents included vice presidents, clinical department directors, and heads of pharmacy. The questionnaire explored four dimensions consistent with China’s national performance appraisal framework: medical quality, operational efficiency, sustainable development, and satisfaction. Data were analyzed using NVivo 14 for qualitative responses and Excel 2021 for quantitative metrics.

The findings revealed that 82.35 percent (14/17) of hospitals lacked dedicated HB-HTA teams, with decisions made primarily by coordination between Medical Affairs Offices (28.89 percent, 13/45) and Pharmacy Departments (22.22 percent, 10/45). Safety (28.26 percent, 13/46), effectiveness (23.91 percent, 11/46), and cost-effectiveness (19.57 percent, 9/46) were prioritized criteria, yet only 29.41 percent (5/17) of institutions used formal HB-HTA tools. Divergence persisted between administrators’ organizational priorities and clinicians’ patient-centered perspectives. Despite barriers reported by 62.8 percent (27/43) of respondents’ institutions, 88.24 percent (15/17) expressed an urgent or recognized need for HB-HTA implementation.

For effective HB-HTA implementation in China, addressing capacity deficits and reconciling stakeholder perspectives is essential. A project-based strategy, supported by government real-world data platforms and interdisciplinary teams, is recommended for contextually-appropriate evaluation frameworks.