"I won't call it rationing...": An ethnographic study of healthcare disinvestment in theory and practice

Social Science and Medicine

Volumn 128, Issue , 2015, Pages 273-281

  Rooshenas, Leila ^a   Owen Smith, Amanda ^a   Hollingworth, William ^a   Badrinath, Padmanabhan ^b   Beynon, Claire ^c   Donovan, Jenny L ^a  

^a UNIVERSITY OF BRISTOL   (United Kingdom)

^b Public Health Suffolk   (United Kingdom)

^c NHS South Gloucestershire South West Commissioning Support   (United Kingdom)

Author keywords

Commissioning; Disinvestment; Healthcare; Priority setting; Qualitative; Rationing; UK

Indexed keywords

DECISION MAKING; GLOBAL ECONOMY; GUIDELINE; HEALTH CARE; IDEOLOGY; RESOURCE ALLOCATION; SERVICE PROVISION;

ARTICLE; COST CONTROL; COST EFFECTIVENESS ANALYSIS; ETHNOGRAPHY; FINANCIAL MANAGEMENT; FUNDING; HEALTH CARE DISINVESTMENT; HEALTH CARE PRACTICE; HEALTH SERVICE; INTERVIEW; MEDICAL DECISION MAKING; PATIENT SAFETY; RESOURCE ALLOCATION; CULTURAL ANTHROPOLOGY; DECISION MAKING; ECONOMICS; HEALTH CARE ORGANIZATION; HEALTH CARE PLANNING; HUMAN; NATIONAL HEALTH SERVICE; POLICY; UNITED KINGDOM;

ENGLAND; UNITED KINGDOM;

ANTHROPOLOGY, CULTURAL; DECISION MAKING; ENGLAND; HEALTH CARE RATIONING; HEALTH PRIORITIES; HUMANS; INTERVIEWS AS TOPIC; ORGANIZATIONAL POLICY; STATE MEDICINE;

EID: 84921640588     PISSN: 02779536     EISSN: 18735347     Source Type: Journal    
DOI: 10.1016/j.socscimed.2015.01.020     Document Type: Article

References (34)

1. Appleby J. Spending on Health and Social Care over the Next 50 Years: Why Think Long Term? 2013, The King's Fund, London, UK.
2. Bohmer P., Pain C., Watt A., Abernethy P., Sceats J. Maximising health gain within available resources in the New Zealand public health system. Health Policy 2001, 55:37-50.
3. Brody H. From an ethics of rationing to an ethics of waste avoidance. N.Engl. J. Med. 2012, 366:1949-1951.
4. Chamberlain C.A., Martin R.M., Busby J., Gilbert R., Cahill D.J., Hollingworth W. Trends in procedures for infertility and caesarean sections: was NICE disinvestment guidance implemented? NICE recommendation reminders. BMC Public Health 2013, 13:112.
5. Cohen D. Marginal analysis in practice: an alternative to needs assessment for contracting health care. BMJ 1994, 309:781-784.
6. Cookson R., McDaid D., Maynard A. Wrong SIGN, NICE mess: is national guidance distorting allocation of resources?. BMJ 2001, 323:743-745.
7. Cooper C., Starkey K. Disinvestment in healthcare. BMJ 2010, 340(1413).
8. Daniels T., Williams I., Robinson S., Spence K. Tackling disinvestment in health care services. The views of resource allocators in the English NHS. J.Health Organ Manag. 2013, 27:762-780.
9. Department of Health Equity and Excellence: Liberating the NHS (White Paper) 2010, The Stationery Office, London. D.o. Health (Ed.).
10. Donaldson C., Bate A., Mitton C., Dionne F., Ruta D. Rational disinvestment. QJM 2010, 103:801-807.
11. Eddama O., Coast J. Use of economic evaluation in local health care decision-making in England: a qualitative investigation. Health Policy 2009, 89:261-270.
12. Elshaug A.G., Hiller J.E., Moss J.R. Exploring policy-makers' perspectives on disinvestment from ineffective healthcare practices. Int. J. Technol. Assess. Health Care 2008, 24:1-9.
13. Elshaug A.G., Hiller J.E., Tunis S.R., Moss J.R. Challenges in Australian policy processes for disinvestment from existing, ineffective health care practices. Aust. N. Z. Health Policy 2007, 4:23.
14. Elshaug A.G., Watt A.M., Mundy L., Willis C.D. Over 150 potentially low-value health care practices: an Australian study. Med. J. Aust. 2012, 197:556-560.
15. Garner S., Littlejohns P. Disinvestment from low value clinical interventions: NICEly done?. BMJ 2011, 343:d4519.
16. Glaser B.G., Strauss A.L. The Discovery of Grounded Theory: Strategies for Qualitative Research 1967, Aldine de Gruyter.
17. Goodwin E., Frew E. Using programme budgeting and marginal analysis (PBMA) to set priorities: reflections from a qualitative assessment in an English Primary Care Trust. Soc. Sci. Med. 2013, 98:162-168.
18. Gutierrez-Ibarluzea I. Evidence-based disinvestment in Spain. Atencion Primaria 2011, 43:3-4.
19. Hodgetts K., Elshaug A.G., Hiller J.E. What counts and how to count it: physicians' constructions of evidence in a disinvestment context. Soc. Sci. Med. 2012, 75:2191-2199.
20. Hollingworth W., Rooshenas L., Busby J., Hine C., Badrinath P., Whiting P., et al. Using clinical practice variations as a method for commissioners and clinicians to identify and prioritise opportunities for disinvestment in health care. Health Serv. Deliv. Res. March 2015, (in press). http://nets.nihr.ac.uk/__data/assets/pdf_file/0004/120964/FLS-09-1006-25.pdf.
21. Hughes D.A., Ferner R.E. New drugs for old: disinvestment and NICE. BMJ 2010, 340:c572.
22. Ibargoyen-Roteta N., Gutierrez-Ibarluzea I., Asua J. Guiding the process of health technology disinvestment. Health Policy 2010, 98:218-226.
23. Kemp L., Fordham R., Robson A., Bate A., Donaldson C., Baughan S., et al. Road Testing Programme Budgeting and Marginal Analysis (PBMA) in Three English Regions: Hull (Diabetes) 2008, Newcastle (CAHMS), Norfolk (Mental Health). York: YHPHO.
24. Leggett L.E., Mackean G., Noseworthy T.W., Sutherland L., Clement F. Current status of health technology reassessment of non-drug technologies: survey and key informant interviews. Health Res. Policy Syst. 2012, 10:38.
25. Mitton C., Donaldson C. Resource allocation in health care: health economics and beyond. Health Care Anal. 2003, 11:245-257.
26. Mitton C., Patten S., Waldner H., Donaldson C. Priority setting in health authorities: a novel approach to a historical activity. Soc. Sci. Med. 2003, 57:1653-1663.
27. NHS Commissioners Clinical Commissioning in Action 2012, NHS Right Care.
28. Nuti S., Vainieri M., Bonini A. Disinvestment for re-allocation: a process to identify priorities in healthcare. Health Policy 2010, 95:137-143.
29. Regier D.,A., Bentley C., Mitton C., Bryan S., Burgess M.M., Chesney E., et al. Public engagement in priority-setting: results from a pan-Canadian survey of decision-makers in cancer control. Soc. Sci. Med. 2014, 122:130-139.
30. Robinson S., Dickinson H., Freeman T., Rumbold B., Williams I. Structures and processes for priority-setting by health-care funders: a national survey of primary care trusts in England. Health Serv. Manage Res. 2012, 25:113-120.
31. Robinson S., Dickinson H., Freeman T., Williams I. Disinvestment in health the challenges facing general practitioner (GP) commissioners. Public Money & Manag. 2011, 31:145-148.
32. Robinson S., Glasby J., Allen K. 'It ain't what you do it's the way that you do it': lessons for health care from decommissioning of older people's services. Health & Soc. Care Community 2013, 21:614-622.
33. Robinson S., Williams I., Dickinson H., Freeman T., Rumbold B. Priority-setting and rationing in healthcare: evidence from the English experience. Soc. Sci. Med. 2012, 75:2386-2393.
34. Williams I.P., Bryan S. Cost-effectiveness analysis and formulary decision making in England: findings from research. Soc. Sci. Med. 2007, 65:2116-2129.