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Table 1 Examples of concepts underpinning disinvestment definitions

From: Sustainability in Health care by Allocating Resources Effectively (SHARE) 2: identifying opportunities for disinvestment in a local healthcare setting

Concept

Definition

Reallocation based on Relative value

“Disinvestment is an explicit process of taking resources from one service in order to use them for other purposes that are believed to be of better value” (Pearson and Littlejohns 2007 [1])

Reallocation based on Absolute value

“Disinvesting in health interventions that offer no or low health gain (eg are unproven, outdated or cost ineffective) provides an opportunity to invest in alternative proven and cost effective health interventions” (Victorian Department of Human Services 2007 [85])

Removal or restriction based on Absolute value

“Disinvestment relates to the withdrawing (partially or completely) of health care practices, procedures, technologies and pharmaceuticals that are deemed to deliver no or low health gain and are thus not efficient or appropriate health resources allocations” (Elshaug et al. [2])