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Exploring policy-makers' perspectives on disinvestment from ineffective healthcare practices

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dc.contributor.authorElshaug, A.
dc.contributor.authorHiller, J.
dc.contributor.authorMoss, J.
dc.date.issued2008
dc.description.abstractObjectives: Many existing healthcare interventions diffused before modern evidence-based standards of clinical- and cost-effectiveness. Disinvestment from ineffective or inappropriately applied practices is growing as a priority for international health policy, both for improved quality of care and sustainability of resource allocation. Australian policy stakeholders were canvassed to assess their perspectives on the challenges and the nature of disinvestment. Methods: Senior health policy stakeholders from Australia were criterion and snow-ball sampled (to identify opinion leaders). Participants were primed with a potential disinvestment case study and took part in individual semistructured interviews that focused on mechanisms and challenges within health policy to support disinvestment. Interviews were taped and transcribed for thematic analysis. Participant comments were de-identified. Results: Ten stakeholders were interviewed before saturation was reached. Three primary themes were identified. (i) The current focus on assessment of new and emerging health technologies/practices and lack of attention toward existing practices is due to resource limitations and methodological complexity. Participants considered a parallel model to that of Australia's current assessment process for new medical technologies is best-positioned to facilitate disinvestment. (ii) To advance the disinvestment agenda requires an explicit focus on the potential for cost-savings coupled with improved quality of care. (iii) Support (financial and collaborative) is needed for research advancement in the methodological underpinnings associated with health technology assessment and for disinvestment specifically. Conclusions: In this exploratory study, stakeholders support the notion that systematic policy approaches to disinvestment will improve equity, efficiency, quality, and safety of health care, as well as sustainability of resource allocation.
dc.description.statementofresponsibilityAdam G. Elshaug, Janet E. Hiller and John R. Moss
dc.identifier.citationInternational Journal of Technology Assessment in Health Care, 2008; 24(1):1-9
dc.identifier.doi10.1017/S0266462307080014
dc.identifier.issn0266-4623
dc.identifier.issn1471-6348
dc.identifier.orcidElshaug, A. [0000-0002-4939-5379]
dc.identifier.orcidHiller, J. [0000-0002-8532-4033]
dc.identifier.orcidMoss, J. [0000-0003-4216-1761]
dc.identifier.urihttp://hdl.handle.net/2440/52659
dc.language.isoen
dc.publisherCambridge Univ Press
dc.rightsCopyright © Cambridge University Press 2008
dc.source.urihttps://doi.org/10.1017/s0266462307080014
dc.subjectDisinvestment
dc.subjectPolicy
dc.subjectStakeholder engagement
dc.subjectHealth technology assessment
dc.subjectObsolescence
dc.subjectCost-effectiveness
dc.titleExploring policy-makers' perspectives on disinvestment from ineffective healthcare practices
dc.typeJournal article
pubs.publication-statusPublished

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