What influences the outcome of active disinvestment processes in healthcare? A qualitative interview study on five recent cases of active disinvestment

Table 1 Number of interviews conducted per case and per respondent group

Case	Respondent group						Total number per case
Case	Patient representatives^a	Healthcare providers^b	Health insurers	National Healthcare Institute (ZINL)	Ministry of health, welfare and sports	Other	Total number per case
Benzodiazepines	1	2	1	2	2	1^c	9
Medication for Fabry disease	1	1	1	1	1	1^d	6
Quit smoking program	1	0^e	1	1	1	3^f	7
Psychoanalytic therapy	1	3^g	1	1	NA^h	1^c	7
Maternity care assistance	1	3ⁱ	1	1	2	0	8
Total over all cases	5	9	5	6	6	6	37

^a This respondent group includes patients or professionals who acted as patient representatives at the time of the disinvestment process
^b The respondent group healthcare providers includes both (leading) individual healthcare providers as well as healthcare provider organizations (e.g. physician associations)
^c i.e. knowledge institute
^d i.e. pharmaceutical company
^e In this case, several interviewees are from interest groups that represent both patients and healthcare providers as well (i.e. different actor groups are united in one organization). Therefore, the healthcare provider perspective has been covered in the other interviews
^f i.e. interest groups + advisor of interest groups
^g In this case, in the first interview with a healthcare provider, we identified two even more involved healthcare providers. Therefore, in total, three interviews with healthcare providers were necessary for this case
^h Disinvestment decisions based on (lack of evidence of) effectiveness can be taken by the National Healthcare Institute and do not need involvement by the Ministry. For this reason, the Ministry was not involved in the disinvestment decision regarding psychoanalytic therapy, and was, hence, not interviewed
ⁱ Several healthcare provider organizations are involved in maternity care assistance. Therefore, we needed three interviews with healthcare providers to interview all relevant healthcare provider organizations

ISSN: 1472-6963