Abstract
Impact of disinvestment from weekend allied health services across acute medical and surgical wards: 2 stepped-wedge cluster randomised controlled trials
Highlights
Disinvestment is the process of withdrawing health resources from any existing healthcare practices, procedures, technologies, or pharmaceuticals that are deemed to deliver little or no health gain for their cost and are not efficient health resource allocations [1]
In Trial 1, criteria to say that the no weekend allied health condition was non-inferior to current weekend allied health condition were not met, while neither the no weekend nor current weekend allied health condition demonstrated superiority
We found that removing the weekend allied health service had an uncertain impact on patient flow and safety, but that having no weekend allied health service on these wards was no worse than having the newly developed service that was brought back in, and was superior for some outcomes
Summary
Disinvestment is the process of (partially or completely) withdrawing health resources from any existing healthcare practices, procedures, technologies, or pharmaceuticals that are deemed to deliver little or no health gain for their cost and are not efficient health resource allocations [1]. We would argue that disinvesting from ineffective services could be seen as being more virtuous and acceptable if entwined with an argument based on opportunity costs: that resources spent delivering ineffective services to one patient are the same resources that can no longer be used to deliver an effective service to improve health outcomes for another. This position is best seen from the perspective of healthcare administrators with finite budgets who must choose between competing services they can offer with their available funds. The aim of this study was to understand the impact of removing weekend allied health services from acute medical and surgical wards using a disinvestment-specific non-inferiority research design
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