Table 1 Possible responses to fiscal stress
From: Decommissioning in a local healthcare system in Sweden: responses to fiscal stress
Responses to fiscal stress | Implementation effort | Economic pay-off | Plausible risks |
|---|---|---|---|
Across-the-board cuts | Easy | Short-term payoff | Long-term quality reduction by penalizing well-functioning and high quality units |
Operational cuts | Easy | Short-term payoff | Long-term loss of important knowledge and skills |
Programme cuts | Moderate | Moderate or long-term payoff | Quality reduction and/or impaired access |
Capital expenditures and investment cuts | Easy | Short-term payoff | Long-term cost increase due to cancelled maintenance |
Structural reforms | Difficult | Potential long-term payoff | Effects difficult to predict. May not lead to desired outcome, or any outcome at all |