IDEAS home Printed from https://ideas.repec.org/a/eee/hepoli/v95y2010i2-3p137-143.html
   My bibliography  Save this article

Disinvestment for re-allocation: A process to identify priorities in healthcare

Author

Listed:
  • Nuti, Sabina
  • Vainieri, Milena
  • Bonini, Anna

Abstract

Resource scarcity and increasing service demand lead health systems to cope with choices within constrained budgets. The aim of the paper is to describe the study carried out in the Tuscan Health System in Italy on how to set priorities in the disinvestment process for re-allocation. The analysis was based on 2007 data benchmarking of the Tuscan Health System with an impact on the level of resources used. For each indicator, the first step was to estimate the gap between the performance of each Health Authority (HA) and the best performance or the regional average. The second step was to measure this gap in terms of financial value. The results of the analysis demonstrated that, at the regional level, 2-7% of the healthcare budget can be re-allocated if all the institutions achieve the regional average or the best practice. The implications of this study can be useful for policy makers and the HA top management. In the context of resource scarcity, it allows managers to identify the areas where the institutions can achieve a higher level of efficiency without negative effects on quality of care and instead re-allocate resources toward services with more value for patients.

Suggested Citation

  • Nuti, Sabina & Vainieri, Milena & Bonini, Anna, 2010. "Disinvestment for re-allocation: A process to identify priorities in healthcare," Health Policy, Elsevier, vol. 95(2-3), pages 137-143, May.
    • Handle: RePEc:eee:hepoli:v:95:y:2010:i:2-3:p:137-143
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0168-8510(09)00296-6
    Download Restriction: Full text for ScienceDirect subscribers only
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Christopher J.L. Murray & David B. Evans & Arnab Acharya & Rob M.P.M. Baltussen, 2000. "Development of WHO guidelines on generalized cost‐effectiveness analysis," Health Economics, John Wiley & Sons, Ltd., vol. 9(3), pages 235-251, April.
    2. Wiseman, V. & Mooney, G. & Berry, G. & Tang, K. C., 2003. "Involving the general public in priority setting: experiences from Australia," Social Science & Medicine, Elsevier, vol. 56(5), pages 1001-1012, March.
    3. Wilson, Hamish & Scott, Sheila, 1995. "PBMA--its role in the future purchasing arrangements for health care services," Health Policy, Elsevier, vol. 33(2), pages 157-160, August.
    4. Mitton, Craig & Patten, San & Waldner, Howard & Donaldson, Cam, 2003. "Priority setting in health authorities: a novel approach to a historical activity," Social Science & Medicine, Elsevier, vol. 57(9), pages 1653-1663, November.
    5. Ham, Chris, 1997. "Priority setting in health care: learning from international experience," Health Policy, Elsevier, vol. 42(1), pages 49-66, October.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Daniel Adrian Lungu & Elisa Foresi & Paolo Belardi & Sabina Nuti & Andrea Giannini & Tommaso Simoncini, 2021. "The Impact of New Surgical Techniques on Geographical Unwarranted Variation: The Case of Benign Hysterectomy," IJERPH, MDPI, vol. 18(13), pages 1-14, June.
    2. Campanale, Cristina & Cinquini, Lino, 2016. "Emerging pathways of colonization in healthcare from participative approaches to management accounting," CRITICAL PERSPECTIVES ON ACCOUNTING, Elsevier, vol. 39(C), pages 59-74.
    3. Marcio L. V. Araujo & José G. V. Miranda & Rodrigo N. Vasconcelos & Elaine C. B. Cambui & Raphael S. Rosário & Márcio C. F. Macedo & Antonio C. Bandeira & Márcia S. P. L. Souza & Ana C. F. N. Silva & , 2022. "A Critical Analysis of the COVID-19 Hospitalization Network in Countries with Limited Resources," IJERPH, MDPI, vol. 19(7), pages 1-10, March.
    4. Carinci, Fabrizio & Caracci, Gianni & Di Stanislao, Francesco & Moirano, Fulvio, 2012. "Performance measurement in response to the Tallinn Charter: Experiences from the decentralized Italian framework," Health Policy, Elsevier, vol. 108(1), pages 60-66.
    5. Rooshenas, Leila & Owen-Smith, Amanda & Hollingworth, William & Badrinath, Padmanabhan & Beynon, Claire & Donovan, Jenny L., 2015. "“I won't call it rationing…”: An ethnographic study of healthcare disinvestment in theory and practice," Social Science & Medicine, Elsevier, vol. 128(C), pages 273-281.
    6. Hao Li & Sara Barsanti & Anna Bonini, 2012. "Building China’s Regional Municipal Healthcare Performance Evaluation System: A Tuscan Perspective," Working Papers 201204, Scuola Superiore Sant'Anna of Pisa, Istituto di Management.
    7. Milena Vainieri & Massimiliano Gallo & Giuseppe Montagano & Sabina Nuti, 2016. "Per migliorare la performance quanto conta l?integrazione tra gli strumenti di governance regionali e aziendali? Alcune evidenze dalla Regione Basilicata," MECOSAN, FrancoAngeli Editore, vol. 2016(98), pages 41-59.
    8. García-Armesto, Sandra & Campillo-Artero, Carlos & Bernal-Delgado, Enrique, 2013. "Disinvestment in the age of cost-cutting sound and fury. Tools for the Spanish National Health System," Health Policy, Elsevier, vol. 110(2), pages 180-185.
    9. Sara Barsanti & Silvia Giovanelli & Sabina Nuti, 2014. "Come valutare la ricerca nelle Aziende Ospedaliero-Universitarie? Metodi e proposte operative," MECOSAN, FrancoAngeli Editore, vol. 2014(90), pages 9-32.
    10. Nuti, Sabina & Seghieri, Chiara, 2014. "Is variation management included in regional healthcare governance systems? Some proposals from Italy," Health Policy, Elsevier, vol. 114(1), pages 71-78.
    11. Seghieri, Chiara & Berta, Paolo & Nuti, Sabina, 2019. "Geographic variation in inpatient costs for Acute Myocardial Infarction care: Insights from Italy," Health Policy, Elsevier, vol. 123(5), pages 449-456.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Rob Baltussen & Elly Stolk & Dan Chisholm & Moses Aikins, 2006. "Towards a multi‐criteria approach for priority setting: an application to Ghana," Health Economics, John Wiley & Sons, Ltd., vol. 15(7), pages 689-696, July.
    2. Michaël Schwarzinger & Jean‐Louis Lanoë & Erik Nord & Isabelle Durand‐Zaleski, 2004. "Lack of multiplicative transitivity in person trade‐off responses," Health Economics, John Wiley & Sons, Ltd., vol. 13(2), pages 171-181, February.
    3. Baltussen, Rob, 2006. "Priority setting of public spending in developing countries: Do not try to do everything for everybody," Health Policy, Elsevier, vol. 78(2-3), pages 149-156, October.
    4. Schoon, Rebecca & Chi, Chunhuei & Liu, Tsai-Ching, 2022. "Quantifying public preferences for healthcare priorities in Taiwan through an integrated citizens jury and discrete choice experiment," Social Science & Medicine, Elsevier, vol. 315(C).
    5. Siying Wang & Liubao Peng & Jianhe Li & Xiaohui Zeng & Lihui Ouyang & Chongqing Tan & Qiong Lu, 2013. "A Trial-Based Cost-Effectiveness Analysis of Erlotinib Alone versus Platinum-Based Doublet Chemotherapy as First-Line Therapy for Eastern Asian Nonsquamous Non–Small-Cell Lung Cancer," PLOS ONE, Public Library of Science, vol. 8(3), pages 1-9, March.
    6. Kleinhout-Vliek, Tineke & de Bont, Antoinette & Boer, Bert, 2017. "The bare necessities? A realist review of necessity argumentations used in health care coverage decisions," Health Policy, Elsevier, vol. 121(7), pages 731-744.
    7. Anderson, Pippa & Webb, Philip & Groves, Sam, 2017. "Prioritisation of specialist health care services; not NICE, not easy but it can be done," Health Policy, Elsevier, vol. 121(9), pages 978-985.
    8. Li, Kathy K. & Abelson, Julia & Giacomini, Mita & Contandriopoulos, Damien, 2015. "Conceptualizing the use of public involvement in health policy decision-making," Social Science & Medicine, Elsevier, vol. 138(C), pages 14-21.
    9. Kang, Minah & Reich, Michael R., 2014. "Between credit claiming and blame avoidance: The changing politics of priority-setting for Korea's National Health Insurance System," Health Policy, Elsevier, vol. 115(1), pages 9-17.
    10. Edward C. F. Wilson & Stuart J. Peacock & Danny Ruta, 2009. "Priority setting in practice: what is the best way to compare costs and benefits?," Health Economics, John Wiley & Sons, Ltd., vol. 18(4), pages 467-478, April.
    11. Brian Reddy & Praveen Thokala & Alison Iliff & Kerry Warhurst & Helen Chambers & Lynsey Bowker & Stephen J. Walters & Alejandra Duenas & Michael P. Kelly, 2016. "Using MCDA to generate and interpret evidence to inform local government investment in public health," EURO Journal on Decision Processes, Springer;EURO - The Association of European Operational Research Societies, vol. 4(3), pages 161-181, November.
    12. Broqvist, Mari & Sandman, Lars & Garpenby, Peter & Krevers, Barbro, 2018. "The meaning of severity – do citizenś views correspond to a severity framework based on ethical principles for priority setting?," Health Policy, Elsevier, vol. 122(6), pages 630-637.
    13. Quartey, Jonathan D. & Nyarko, Lydia Gyamea, 2022. "Economic Sustainability of Mobile Money Payments in Ghana: Does a Tax on Transactions Matter?," African Journal of Economic Review, African Journal of Economic Review, vol. 10(5), December.
    14. Ahumada-Canale, Antonio & Jeet, Varinder & Bilgrami, Anam & Seil, Elizabeth & Gu, Yuanyuan & Cutler, Henry, 2023. "Barriers and facilitators to implementing priority setting and resource allocation tools in hospital decisions: A systematic review," Social Science & Medicine, Elsevier, vol. 322(C).
    15. Thurston, Wilfreda E. & MacKean, Gail & Vollman, Ardene & Casebeer, Ann & Weber, Myron & Maloff, Bretta & Bader, Judy, 2005. "Public participation in regional health policy: a theoretical framework," Health Policy, Elsevier, vol. 73(3), pages 237-252, September.
    16. Lai, Taavi & Habicht, Jarno & Reinap, Marge & Chisholm, Dan & Baltussen, Rob, 2007. "Costs, health effects and cost-effectiveness of alcohol and tobacco control strategies in Estonia," Health Policy, Elsevier, vol. 84(1), pages 75-88, November.
    17. Martin, Douglas K. & Giacomini, Mita & Singer, Peter A., 2002. "Fairness, accountability for reasonableness, and the views of priority setting decision-makers," Health Policy, Elsevier, vol. 61(3), pages 279-290, September.
    18. Armstrong, Kristy & Mitton, Craig & Carleton, Bruce & Shoveller, Jean, 2008. "Drug formulary decision-making in two regional health authorities in British Columbia, Canada," Health Policy, Elsevier, vol. 88(2-3), pages 308-316, December.
    19. Rooshenas, Leila & Owen-Smith, Amanda & Hollingworth, William & Badrinath, Padmanabhan & Beynon, Claire & Donovan, Jenny L., 2015. "“I won't call it rationing…”: An ethnographic study of healthcare disinvestment in theory and practice," Social Science & Medicine, Elsevier, vol. 128(C), pages 273-281.
    20. Benning, Tim M. & Dellaert, Benedict G.C., 2013. "Paying more for faster care? Individuals' attitude toward price-based priority access in health care," Social Science & Medicine, Elsevier, vol. 84(C), pages 119-128.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:hepoli:v:95:y:2010:i:2-3:p:137-143. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu or the person in charge (email available below). General contact details of provider: http://www.elsevier.com/locate/healthpol .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.