The ASTUTE Health study protocol: Deliberative stakeholder engagements to inform implementation approaches to healthcare disinvestment

Implementation Science

Adam G Elshaug⁴  Jackie M Street³  Katherine Hodgetts³  Dagmara E Riitano³  Janet Wale³  Heather Buchan²  John R Moss³  Annette J Braunack-Mayer³  Janet E Hiller¹  Amber M Watt³ 

[1] Faculty of Health Sciences, Australian Catholic University, 115 Victoria Parade, Fitzroy, VIC, Australia;Australian Commission on Safety and Quality in Health Care, 1 Oxford Street, Darlinghurst, NSW, Australia;School of Population Health, The University of Adelaide, North Terrace, Adelaide, SA, Australia;The Commonwealth Fund, One East 75th Street, New York, NY, USA

关键词: Policy;    Disinvestment;    User involvement;    Public participation;   

Others  :  813890
DOI  :  10.1186/1748-5908-7-101

 received in 2012-08-08, accepted in 2012-10-17,  发布年份 2012

【 摘 要 】

Background

Governments and other payers are yet to determine optimal processes by which to review the safety, effectiveness, and cost-effectiveness of technologies and procedures that are in active use within health systems, and rescind funding (partially or fully) from those that display poor profiles against these parameters. To further progress a disinvestment agenda, a model is required to support payers in implementing disinvestment in a transparent manner that may withstand challenge from vested interests and concerned citizens. Combining approaches from health technology assessment and deliberative democratic theory, this project seeks to determine if and how wide stakeholder engagement can contribute to improved decision-making processes, wherein the views of both vested and non-vested stakeholders are seen to contribute to informing policy implementation within a disinvestment context.

Methods/design

Systematic reviews pertaining to illustrative case studies were developed and formed the evidence base for discussion. Review findings were presented at a series of deliberative, evidence-informed stakeholder engagements, including partisan (clinicians and consumers) and non-partisan (representative community members) stakeholders. Participants were actively facilitated towards identifying shared and dissenting perspectives regarding public funding policy for each of the case studies and developing their own funding models in response to the evidence presented. Policy advisors will subsequently be invited to evaluate disinvestment options based on the scientific and colloquial evidence presented to them, and to explore the value of this information to their decision-making processes with reference to disinvestment.

Discussion

Analysis of the varied outputs of the deliberative engagements will contribute to the methodological development around how to best integrate scientific and colloquial evidence for consideration by policy advisors. It may contribute to the legitimization of broad and transparent stakeholder engagement in this context. It is anticipated that decision making will benefit from the knowledge delivered through informed deliberation with engaged stakeholders, and this will be explored through interviews with key decision makers.

【 授权许可】

   
2012 Watt et al.; licensee BioMed Central Ltd.

【 图 表 】

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