PP132 Disinvestment Initiatives In Health Care: A Scoping Review Of Systematic Reviews

Introduction Disinvestment of ineffective, low value technologies is growing as a priority for international health policy in order to improve quality and maximize care. Different strategies have been implemented at the national level using various methods evidence gathering technical assessment. However, success these initiatives mixed, with fewer than half empirical studies reporting reductions use services. This review explored role stakeholders disinvestment process by describing analyzing used reassessment. We also identified facilitators barriers related implementation. Methods scoping was guided JBI Manual Evidence Synthesis PRISMA statement reviews. Strategic literature searches were performed identify published reviews on care MEDLINE, Web Science, Scopus databases. Data extracted predesigned form then synthesized narratively similarities differences across approaches according prespecified domains. Results Sixteen included. 16 countries, minimum 34 different levels implementation agencies responsible activities. Two most facilitating decisions program budgeting marginal analysis (PBMA) technology assessment (HTA). Stakeholder involvement important aspect be addressed since it acts both facilitator barrier implementing initiatives. Meaningful engagement may strengthened continuous stakeholder participation, transparency processes, ongoing knowledge transfer. Conclusions highlights disinvestment, which double-edged sword because facilitates hinders The common assessing candidates are PBMA HTA, but there lack clarity HTA dimension suitable process.