Breaking up is hard to do: Why disinvestment in medical technology is harder than investment

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dc.contributor.author Haas, M
dc.contributor.author Hall, J
dc.contributor.author Viney, R
dc.contributor.author Gallego, G
dc.date.accessioned 2012-10-12T03:34:54Z
dc.date.issued 2012
dc.identifier.citation Australian Health Review, 2012, 36 (2), pp. 148 - 152
dc.identifier.issn 0156-5788
dc.identifier.other C1 en_US
dc.identifier.uri http://hdl.handle.net/10453/18810
dc.description.abstract Healthcare technology is a two-edged sword - it offers new and better treatment to a wider range of people and, at the same time, is a major driver of increasing costs in health systems. Many countries have developed sophisticated systems of health technology assessment (HTA) to inform decisions about new investments in new healthcare interventions. In this paper, we question whether HTA is also the appropriate framework for guiding or informing disinvestment decisions. In exploring the issues related to disinvestment, we first discuss the various HTA frameworks which have been suggested as a means of encouraging or facilitating disinvestment. We then describe available means of identifying candidates for disinvestment (comparative effectiveness research, clinical practice variations, clinical practice guidelines) and for implementing the disinvestment process (program budgeting and marginal analysis (PBMA) and related techniques). In considering the possible reasons for the lack of progress in active disinvestment, we suggest that HTA is not the right framework as disinvestment involves a different decision making context. The key to disinvestment is not just what to stop doing but how to make it happen - that is, decision makers need to be aware of funding disincentives. What is known about this topic? Disinvestment is an increasingly popular topic amongst academics and policy makers. Most discussions focus on the need to increase disinvestment as a corollary of investment, the lack of overt disinvestment decisions and the use of a framework based on health technology assessment (HTA) to implement disinvestment. What does this paper add? This paper focusses on the difficulties associated with deciding which technologies to disinvest in, and the problems in using an HTA framework to make such decisions, when disinvestment involves a different decision making context from that of investment. What are the implications for practitioners? The key to disinvestment is not just what to stop doing but how to implement such decisions. Making it happen means being aware of funding disincentives. © 2012 AHHA.
dc.language eng
dc.relation.hasversion Accepted manuscript version
dc.relation.isbasedon 10.1071/AH11032
dc.title Breaking up is hard to do: Why disinvestment in medical technology is harder than investment
dc.type Journal Article
dc.description.version Published
dc.parent Australian Health Review
dc.journal.volume 2
dc.journal.volume 36
dc.journal.number 2 en_US
dc.publocation Canberra en_US
dc.identifier.startpage 148 en_US
dc.identifier.endpage 152 en_US
dc.cauo.name BUS.Centre for Health Economics Research and Evaluation en_US
dc.conference Verified OK en_US
dc.for 140208 Health Economics
dc.personcode 020119
dc.personcode 020117
dc.personcode 020116
dc.personcode 102201
dc.percentage 100 en_US
dc.classification.name Health Economics en_US
dc.classification.type FOR-08 en_US
dc.edition en_US
dc.custom en_US
dc.date.activity en_US
dc.location.activity en_US
dc.description.keywords en_US
dc.description.keywords Social Sciences
dc.description.keywords Area Studies
dc.description.keywords AREA STUDIES
dc.description.keywords Humans
dc.description.keywords Cost-Benefit Analysis
dc.description.keywords Investments
dc.description.keywords Technology Assessment, Biomedical
dc.description.keywords Decision Making, Organizational
dc.description.keywords Australia
dc.description.keywords Comparative Effectiveness Research
pubs.embargo.period Not known
pubs.organisational-group /University of Technology Sydney
pubs.organisational-group /University of Technology Sydney/Faculty of Business
pubs.organisational-group /University of Technology Sydney/Strength - Health Economics and Research Evaluation
utslib.copyright.status Open Access
utslib.copyright.date 2015-04-15 12:23:47.074767+10
utslib.collection.history General (ID: 2)
utslib.collection.history Uncategorised (ID: 363)


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