Airoldi, Mara (2013) Disinvestments in practice: overcoming resistance to change through a sociotechnical approach with local stakeholders. Journal of Health Politics, Policy and Law, 38 (6). pp. 1149-1171. ISSN 0361-6878
Full text not available from this repository.Abstract
For health care, economists have developed cost-effectiveness analysis (CEA) as a “rational,” analytic tool to set priorities. Attempts to use CEA to decide how to cut expenditures, however, have been met with stakeholders' resistance. This article presents an illustrative case study of the application of an approach explicitly designed to engage stakeholders with conflicting objectives in confronting tightening budgets. The outcome of this process, which engaged a group of stakeholders including patients, caregivers, clinicians, and managers, was a strategy that reconfigured services to produce more health gain at reduced total cost. I argue that the key factors that led to overcoming resistance to change were (1) the collective character of the deliberations; (2) the analysis of the whole pathway; (3) the presence of patients; and (4) the development of a model based on CEA principles, which provided a credible rationale for difficult decisions.
| Item Type: | Article |
|---|---|
| Official URL: | http://jhppl.dukejournals.org/ |
| Additional Information: | © 2013 Duke University Press |
| Divisions: | Management LSE Health |
| Subjects: | H Social Sciences > HD Industries. Land use. Labor > HD28 Management. Industrial Management R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine |
| Date Deposited: | 04 Dec 2014 15:12 |
| Last Modified: | 14 Sep 2024 05:56 |
| URI: | http://eprints.lse.ac.uk/id/eprint/51271 |
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