ISSUE:

Operating in an economic environment of increased pressures and resource scarcity, the when and how (not why) of healthcare disinvestment is increasingly discussed in academia. Disinvestment can play an important role in helping a healthcare system to meet efficiency and equity goals and hence alleviate some of these pressures. However, theory around disinvestment has not necessarily been translated to practice and there remain various efficiency and equity concerns from different stakeholders (payers, patients, public, industry and healthcare professionals). In this context, it is important to evaluate and discuss practical considerations regarding when disinvestment can be most necessary or beneficial, how it can be implemented to alleviate pressures, and influences based on the healthcare system in question.

OVERVIEW:

Naomi van Hest will introduce the topic of healthcare disinvestment (5 minutes), moderate discussion and challenge the panellists on the why, what, when and how of disinvestment for the healthcare system they’re representing. Dr André Azaredo will present on the 'tried and tested' experience of disinvestment in Brazil, and the challenges that were faced, as well as the current work on disinvestment that is in development within the United Health System (SUS) (12 minutes). Dr Rosmin Esmail will provide a perspective on the role of disinvestment within an established healthcare system (Canada, amongst others), considering it as one output of the health technology reassessment process guided by the field of knowledge translation (12 minutes). Hanin Kamaruzaman will represent a developing healthcare system perspective, presenting on the applicability of disinvestment to LMICs (e.g. Malaysia) based on her research in the field (12 minutes). Discussion time will be included (15 minutes) and audience participation encouraged throughout, with interactive voting used to gain audience input.