OBJECTIVES: To obtain insight in the considerations that citizens find relevant with regard to decisions on the disinvestment of healthcare interventions and services, this study aimed to discern the societal views on the active disinvestment of healthcare interventions and services (i.e. stopping reimbursement by means of a policy decision) and elicit the considerations that are deemed important by people holding these views.

METHODS: A Q-methodology study was conducted among a purposively selected sample of Dutch citizens (n=43). Data were collected in six group sessions, held in June and July 2019, in which participants individually ranked a set of 43 statements on a wide range of potentially relevant considerations in the disinvestment context from ‘least agree’ to ‘most agree’. Qualitative feedback on the ranking was collected as well using a questionnaire. Principal component analysis followed by oblimin rotation was used to identify clusters of participants with similar rankings, interpreted as distinct viewpoints. Factor arrays and questionnaire responses were used to interpret the viewpoints.

RESULTS: Four distinct viewpoints on active disinvestment and on considerations that are deemed relevant in this context were identified: 1) Entitlement to necessary care, irrespective of the costs, 2) Entitlement to necessary care, but within reasonable limits, 3) Deliberate and fair spending of the healthcare budget, and 4) Transparent and consistent decision-making.

CONCLUSIONS: This study discerned four distinct societal viewpoints on considerations that should be taken into account in the active disinvestment of healthcare interventions and services. These results help us to better understand current controversies around disinvestment, and provide policy makers with guidance to identify cases for disinvestment that are most likely to receive public support.