Hi Ben,
I have worked a lot in this area and suggest there are two reasons why examples are relatively hard to come by. First, many initiatives occur within government/payer and/or provider environments where there is less incentive to publish in the traditional academic sense. A bias of sorts that sees the work hidden. Second, for too long the field focussed on a myth of disinvestment/removal in toto but of course most disinvestment requires a reduction in use not complete removal (with a few exceptions) - a refinement of the indications to reduce creep and overuse. Many QI programs fit this latter conception so are harder to isolate as 'disinvestment' initiatives. To point, I wrote a paper title "De-adoption and its 43 related terms" https://www.ncbi.nlm.nih.gov/pubmed/26486727
Here is a very recent review article (although I have some critiques of it): https://www.ncbi.nlm.nih.gov/pubmed/31831086
Here are some examples that I am involved in/have been directly involved in over the years:
The HQO Appropriateness Initiative. For me one of the most successful initiatives in the area but to my point above very hard to find information online:
https://www.hqontario.ca/Portals/0/Documents/evidence/reports/recommendation-appropriateness-phase-1-130722-en.pdf
https://www.ncbi.nlm.nih.gov/pubmed/26290289
After NICE's disinvestment initiatives of the early 2000s this is the modern iteration (there is another 'round' of services [a list] to be released any day now):
https://www.england.nhs.uk/evidence-based-interventions/
Australia's Medicare FFS Review:
https://www1.health.gov.au/internet/main/publishing.nsf/Content/MBSReviewTaskforce
Basque's GuNFT project
https://www.ncbi.nlm.nih.gov/pubmed/20638745
And here are some papers:
https://www.ncbi.nlm.nih.gov/pubmed/26048353
https://www.ncbi.nlm.nih.gov/pubmed/23514665
https://www.ncbi.nlm.nih.gov/pubmed/24290335
https://www.ncbi.nlm.nih.gov/pubmed/28077228
Finally, my point about disinvestment overlapping QI projects is best presented via Niven's excellent collection of publications:
https://www.ncbi.nlm.nih.gov/pubmed/?term=niven+d
Regards
Adam
Adam Elshaug, MPH, PhD
Professor of Health Policy | Co-Director
Menzies Centre for Health Policy
THE UNIVERSITY OF SYDNEY | Australia
Visiting Fellow
USC-Brookings Schaeffer Initiative for Health Policy
THE BROOKINGS INSTITUTION | Washington DC | USA
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-----Original Message-----
From: Evidence based health (EBH) <[log in to unmask]> On Behalf Of Benjamin Djulbegovic MD
Sent: Thursday, 16 January 2020 9:05 PM
To: [log in to unmask]
Subject: Examples of successful de-implementation strategies....
Dear all,
For all discussion about waste, overRx etc, there appears to be paucity of successful de-implementation examples. I would appreciate it if you can send me the examples of successful de-implementation strategies that you are aware of. I will then compile the list and share with all.
Thanks
Ben djulbegovic
Sent from my iPad - excuse typos and brevity
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