Grant: Travel Awards - Institute Community Support

With the recent economic crisis still affecting global economies, governments around the world are in a difficult position: there is an urgent need to reduce costs while maximizing benefits within a more limited budget. This is particularly true in publicly-funded health care, where limited resources must address the needs of a diverse and aging population. While much of the current research focuses on how to determine which services should be funded, strategies to reduce costs, or what is often called disinvestment, are limited. One of the greatest challenges to disinvestment is the strong public opposition to the reduction of long-running health care services and the political fall-out that ensues. While opposition will always be part of health care funding and priority setting, having disinvestment strategies in place with clear guidelines, criteria, and decision making steps ensures a fair and transparent process. After reviewing all the information available in the literature on how government, non-profit organizations and businesses make decisions on reducing costs, and in collaboration with decision makers and other researchers, we used this knowledge to develop a disinvestment decision making process. This process is comprised of eight steps that will enable an organization to engage multiple stakeholders in setting priorities and determining where and how costs can be reduced. Currently, the process is being trialed within a local health authority to assess its feasibility. To date, no such disinvestment decision tool is available. Equipping decision makers with a defined process will ensure that limited resources are used more effectively and fairly across the health care system.