Disinvestment in healthcare: a scoping review of systematic reviews

Kamaruzaman, H., Grieve, E. and Wu, O. (2022) Disinvestment in healthcare: a scoping review of systematic reviews. International Journal of Technology Assessment in Health Care, 38(1), e69. (doi: 10.1017/S0266462322000514) (PMID:35853843)

Abstract

Objectives: Disinvestment from low value health technologies is growing globally. Diverse evidence gathering and assessment methods were used to implement disinvestment initiatives, however, less than half of the empirical studies report reduced use of the low-value services. This scoping review aimed to synthesize the information from available reviews on the concepts and purposes of disinvestment in healthcare, the approaches and methods used, the role of stakeholders and facilitators and barriers in its implementation. Methods: This scoping review was guided by the Joanna Briggs Institute Manual for Evidence Synthesis and PRISMA statement for scoping review. Published reviews on disinvestment were identified from scientific databases including health technology assessment (HTA) Web sites using the terms “disinvestment,” “health technology reassessment,” and “healthcare.” The data obtained was synthesized narratively to identify similarities and differences across the approaches based on the prespecified categories. Results: Seventeen reviews were included with thirty-four initiatives identified across sixteen countries at various levels of implementation and responsible agencies for the activities. Two most used methods to facilitate disinvestment decisions are Programme Budgeting and Marginal Analysis (PBMA) and HTA. Stakeholder involvement is the most important aspect to be addressed, as it acts as both facilitator and barrier in disinvestment initiatives implementation. Conclusions: Disinvestment programs have been implemented at multilevel, involving multistakeholders and using multiple methods such as PBMA and HTA. However, there is a lack of clarity on the additional dimensions of technical analysis related to these tools. Further research could focus on technology optimization in healthcare as part of overall health technology management.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Grieve, Dr Eleanor and Kamaruzaman, Hanin and Wu, Professor Olivia
• Authors: Kamaruzaman, H., Grieve, E., and Wu, O.
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Health Economics and Health Technology Assessment
• Journal Name: International Journal of Technology Assessment in Health Care
• Publisher: Cambridge University Press
• ISSN: 0266-4623
• ISSN (Online): 1471-6348
• Published Online: 20 July 2022
• Copyright Holders: Copyright © 2022 The Authors
• First Published: First published in International Journal of Technology Assessment in Health Care 38(1): e69
• Publisher Policy: Reproduced in accordance with the publisher copyright policy