{"id":"https://openalex.org/W2134188352","doi":"https://doi.org/10.1071/ah11032","title":"Breaking up is hard to do: why disinvestment in medical technology is harder than investment","display_name":"Breaking up is hard to do: why disinvestment in medical technology is harder than investment","publication_year":2012,"publication_date":"2012-05-24","ids":{"openalex":"https://openalex.org/W2134188352","doi":"https://doi.org/10.1071/ah11032","mag":"2134188352","pmid":"https://pubmed.ncbi.nlm.nih.gov/22624634"},"language":"en","primary_location":{"id":"doi:10.1071/ah11032","doi":"https://doi.org/10.1071/ah11032","is_oa":false,"landing_page_url":"https://doi.org/10.1071/ah11032","pdf_url":null,"source":{"id":"https://openalex.org/S176070599","display_name":"Australian Health Review","issn_l":"0156-5788","issn":["0156-5788","1449-8944"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","dongbi-d","jufo-1","ki-jl-1","medline","norway-1","poland-70","russia-white-list-2","vabb-shw"],"host_organization":"https://openalex.org/P4310320302","host_organization_name":"CSIRO Publishing","host_organization_lineage":["https://openalex.org/P4310320302"],"host_organization_lineage_names":["CSIRO Publishing"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Australian Health Review","raw_type":"journal-article"},"volume":null,"type":"article","indexed_in":["crossref","pubmed"],"open_access":{"is_oa":false,"oa_status":"closed","oa_url":null,"any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5033343360","display_name":"Marion R. Haas","orcid":"https://orcid.org/0000-0002-9726-3063","observed_orcids":["https://orcid.org/0000-0002-9726-3063"]},"institutions":[{"id":"https://openalex.org/I114017466","display_name":"University of Technology Sydney","ror":"https://ror.org/03f0f6041","country_code":"AU","type":"education","lineage":["https://openalex.org/I114017466"]}],"countries":["AU"],"is_corresponding":true,"raw_author_name":"Marion Haas","raw_affiliation_strings":["ACentre for Health Economics Research and Evaluation, University of Technology Sydney, PO Box 123, Broadway, NSW 2007, Australia. Email: jane.hall@chere.uts.edu.au","CCorresponding author. Email: marion.haas@chere.uts.edu.au","Centre for Health Economics Research and Evaluation, University of Technology, Sydney, PO BOX 123, Broadway, NSW, 2007, Australia,"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"ACentre for Health Economics Research and Evaluation, University of Technology Sydney, PO Box 123, Broadway, NSW 2007, Australia. Email: jane.hall@chere.uts.edu.au","institution_ids":["https://openalex.org/I114017466"]},{"raw_affiliation_string":"CCorresponding author. Email: marion.haas@chere.uts.edu.au","institution_ids":[]},{"raw_affiliation_string":"Centre for Health Economics Research and Evaluation, University of Technology, Sydney, PO BOX 123, Broadway, NSW, 2007, Australia,","institution_ids":["https://openalex.org/I114017466"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5058184607","display_name":"Jane P Hall","orcid":"https://orcid.org/0000-0002-2191-0543","observed_orcids":["https://orcid.org/0000-0002-2191-0543"]},"institutions":[{"id":"https://openalex.org/I114017466","display_name":"University of Technology Sydney","ror":"https://ror.org/03f0f6041","country_code":"AU","type":"education","lineage":["https://openalex.org/I114017466"]},{"id":"https://openalex.org/I4210134318","display_name":"University of Technology","ror":"https://ror.org/03gbw6p94","country_code":"RU","type":"education","lineage":["https://openalex.org/I4210134318"]}],"countries":["AU","RU"],"is_corresponding":false,"raw_author_name":"Jane Hall","raw_affiliation_strings":["ACentre for Health Economics Research and Evaluation, University of Technology Sydney, PO Box 123, Broadway, NSW 2007, Australia. Email: jane.hall@chere.uts.edu.au","Centre for Health Economics Research and Evaluation, University of Technology"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"ACentre for Health Economics Research and Evaluation, University of Technology Sydney, PO Box 123, Broadway, NSW 2007, Australia. Email: jane.hall@chere.uts.edu.au","institution_ids":["https://openalex.org/I114017466"]},{"raw_affiliation_string":"Centre for Health Economics Research and Evaluation, University of Technology","institution_ids":["https://openalex.org/I4210134318"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5076742980","display_name":"Rosalie C. Viney","orcid":"https://orcid.org/0000-0002-0039-9635","observed_orcids":["https://orcid.org/0000-0002-0039-9635"]},"institutions":[{"id":"https://openalex.org/I114017466","display_name":"University of Technology Sydney","ror":"https://ror.org/03f0f6041","country_code":"AU","type":"education","lineage":["https://openalex.org/I114017466"]},{"id":"https://openalex.org/I4210134318","display_name":"University of Technology","ror":"https://ror.org/03gbw6p94","country_code":"RU","type":"education","lineage":["https://openalex.org/I4210134318"]}],"countries":["AU","RU"],"is_corresponding":false,"raw_author_name":"Rosalie Viney","raw_affiliation_strings":["ACentre for Health Economics Research and Evaluation, University of Technology Sydney, PO Box 123, Broadway, NSW 2007, Australia. Email: jane.hall@chere.uts.edu.au","Centre for Health Economics Research and Evaluation, University of Technology"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"ACentre for Health Economics Research and Evaluation, University of Technology Sydney, PO Box 123, Broadway, NSW 2007, Australia. Email: jane.hall@chere.uts.edu.au","institution_ids":["https://openalex.org/I114017466"]},{"raw_affiliation_string":"Centre for Health Economics Research and Evaluation, University of Technology","institution_ids":["https://openalex.org/I4210134318"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5079497865","display_name":"Gisselle Gallego","orcid":"https://orcid.org/0000-0002-3243-8176","observed_orcids":["https://orcid.org/0000-0002-3243-8176"]},"institutions":[{"id":"https://openalex.org/I129604602","display_name":"The University of Sydney","ror":"https://ror.org/0384j8v12","country_code":"AU","type":"education","lineage":["https://openalex.org/I129604602"]},{"id":"https://openalex.org/I4210134318","display_name":"University of Technology","ror":"https://ror.org/03gbw6p94","country_code":"RU","type":"education","lineage":["https://openalex.org/I4210134318"]}],"countries":["AU","RU"],"is_corresponding":false,"raw_author_name":"Gisselle Gallego","raw_affiliation_strings":["BCommunity Based Health Care Research Unit, Faculty of Health Sciences, University of Sydney, PO Box 170, Lidcombe, NSW 1825, Australia. Email: gisselle.gallego@usyd.edu.au","Centre for Health Economics Research and Evaluation, University of Technology"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"BCommunity Based Health Care Research Unit, Faculty of Health Sciences, University of Sydney, PO Box 170, Lidcombe, NSW 1825, Australia. Email: gisselle.gallego@usyd.edu.au","institution_ids":["https://openalex.org/I129604602"]},{"raw_affiliation_string":"Centre for Health Economics Research and Evaluation, University of Technology","institution_ids":["https://openalex.org/I4210134318"]}]}],"institutions":[],"countries_distinct_count":2,"institutions_distinct_count":3,"corresponding_author_ids":["https://openalex.org/A5033343360"],"corresponding_institution_ids":["https://openalex.org/I114017466"],"apc_list":null,"apc_paid":null,"fwci":5.3373,"has_fulltext":false,"cited_by_count":67,"citation_normalized_percentile":{"value":0.95338614,"is_in_top_1_percent":false,"is_in_top_10_percent":true},"cited_by_percentile_year":{"min":89,"max":99},"biblio":{"volume":"36","issue":"2","first_page":"148","last_page":"152"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10804","display_name":"Health Systems, Economic Evaluations, Quality of Life","score":0.9688000082969666,"subfield":{"id":"https://openalex.org/subfields/2002","display_name":"Economics and Econometrics"},"field":{"id":"https://openalex.org/fields/20","display_name":"Economics, Econometrics and Finance"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}},"topics":[{"id":"https://openalex.org/T10804","display_name":"Health Systems, Economic Evaluations, Quality of Life","score":0.9688000082969666,"subfield":{"id":"https://openalex.org/subfields/2002","display_name":"Economics and Econometrics"},"field":{"id":"https://openalex.org/fields/20","display_name":"Economics, Econometrics and Finance"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}},{"id":"https://openalex.org/T13555","display_name":"Healthcare cost, quality, practices","score":0.01889999955892563,"subfield":{"id":"https://openalex.org/subfields/3600","display_name":"General Health Professions"},"field":{"id":"https://openalex.org/fields/36","display_name":"Health Professions"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T12781","display_name":"Global Health Care Issues","score":0.0034000000450760126,"subfield":{"id":"https://openalex.org/subfields/3600","display_name":"General Health Professions"},"field":{"id":"https://openalex.org/fields/36","display_name":"Health Professions"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/divestment","display_name":"divestiture","score":0.7749999761581421},{"id":"https://openalex.org/keywords/health-technology-assessment","display_name":"health technology assessment","score":0.9660000205039978},{"id":"https://openalex.org/keywords/health-care-costs","display_name":"health care costs","score":0.5040000081062317},{"id":"https://openalex.org/keywords/comparative-effectiveness-research","display_name":"comparative effectiveness research","score":0.8999999761581421},{"id":"https://openalex.org/keywords/variation-in-clinical-practice","display_name":"clinical practice variation","score":0.8510000109672546},{"id":"https://openalex.org/keywords/health-technology-investment","display_name":"health technology investment","score":0.5249999761581421},{"id":"https://openalex.org/keywords/health-policy-decision-making","display_name":"health policy decision-making","score":0.550000011920929}],"concepts":[{"id":"https://openalex.org/C43609274","wikidata":"https://www.wikidata.org/wiki/Q5282250","display_name":"Disinvestment","level":3,"score":0.9938104152679443},{"id":"https://openalex.org/C21333345","wikidata":"https://www.wikidata.org/wiki/Q1519843","display_name":"Health technology","level":3,"score":0.6489357948303223},{"id":"https://openalex.org/C160735492","wikidata":"https://www.wikidata.org/wiki/Q31207","display_name":"Health care","level":2,"score":0.514167308807373},{"id":"https://openalex.org/C27415008","wikidata":"https://www.wikidata.org/wiki/Q7256382","display_name":"Psychological intervention","level":2,"score":0.47512751817703247},{"id":"https://openalex.org/C524218345","wikidata":"https://www.wikidata.org/wiki/Q31218","display_name":"Health economics","level":3,"score":0.45507892966270447},{"id":"https://openalex.org/C47344431","wikidata":"https://www.wikidata.org/wiki/Q1519812","display_name":"Health policy","level":3,"score":0.43753644824028015},{"id":"https://openalex.org/C2779343474","wikidata":"https://www.wikidata.org/wiki/Q3109175","display_name":"Context (archaeology)","level":2,"score":0.42604848742485046},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.41996246576309204},{"id":"https://openalex.org/C100001284","wikidata":"https://www.wikidata.org/wiki/Q2248246","display_name":"Public economics","level":1,"score":0.4102702736854553},{"id":"https://openalex.org/C162324750","wikidata":"https://www.wikidata.org/wiki/Q8134","display_name":"Economics","level":0,"score":0.3634878098964691},{"id":"https://openalex.org/C162118730","wikidata":"https://www.wikidata.org/wiki/Q1128453","display_name":"Actuarial science","level":1,"score":0.33638641238212585},{"id":"https://openalex.org/C50522688","wikidata":"https://www.wikidata.org/wiki/Q189833","display_name":"Economic growth","level":1,"score":0.2714191675186157},{"id":"https://openalex.org/C159110408","wikidata":"https://www.wikidata.org/wiki/Q121176","display_name":"Nursing","level":1,"score":0.1301788091659546},{"id":"https://openalex.org/C29122968","wikidata":"https://www.wikidata.org/wiki/Q1414816","display_name":"Incentive","level":2,"score":0.11708757281303406},{"id":"https://openalex.org/C175444787","wikidata":"https://www.wikidata.org/wiki/Q39072","display_name":"Microeconomics","level":1,"score":0.0},{"id":"https://openalex.org/C86803240","wikidata":"https://www.wikidata.org/wiki/Q420","display_name":"Biology","level":0,"score":0.0},{"id":"https://openalex.org/C151730666","wikidata":"https://www.wikidata.org/wiki/Q7205","display_name":"Paleontology","level":1,"score":0.0}],"mesh":[{"descriptor_ui":"D001315","descriptor_name":"Australia","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D003362","descriptor_name":"Cost-Benefit Analysis","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D003659","descriptor_name":"Decision Making, Organizational","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D007449","descriptor_name":"Investments","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D013673","descriptor_name":"Technology Assessment, Biomedical","qualifier_ui":"Q000191","qualifier_name":"economics","is_major_topic":true},{"descriptor_ui":"D013673","descriptor_name":"Technology Assessment, Biomedical","qualifier_ui":"Q000592","qualifier_name":"standards","is_major_topic":false},{"descriptor_ui":"D057186","descriptor_name":"Comparative Effectiveness Research","qualifier_ui":"Q000191","qualifier_name":"economics","is_major_topic":true},{"descriptor_ui":"D057186","descriptor_name":"Comparative Effectiveness Research","qualifier_ui":"Q000379","qualifier_name":"methods","is_major_topic":false},{"descriptor_ui":"D057186","descriptor_name":"Comparative Effectiveness Research","qualifier_ui":"Q000639","qualifier_name":"trends","is_major_topic":false}],"locations_count":3,"locations":[{"id":"doi:10.1071/ah11032","doi":"https://doi.org/10.1071/ah11032","is_oa":false,"landing_page_url":"https://doi.org/10.1071/ah11032","pdf_url":null,"source":{"id":"https://openalex.org/S176070599","display_name":"Australian Health Review","issn_l":"0156-5788","issn":["0156-5788","1449-8944"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","dongbi-d","jufo-1","ki-jl-1","medline","norway-1","poland-70","russia-white-list-2","vabb-shw"],"host_organization":"https://openalex.org/P4310320302","host_organization_name":"CSIRO Publishing","host_organization_lineage":["https://openalex.org/P4310320302"],"host_organization_lineage_names":["CSIRO Publishing"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Australian Health Review","raw_type":"journal-article"},{"id":"pmid:22624634","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/22624634","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Australian health review : a publication of the Australian Hospital Association","raw_type":"Journal Article"},{"id":"pmh:oai:opus.lib.uts.edu.au:10453/18810","doi":null,"is_oa":false,"landing_page_url":"http://hdl.handle.net/10453/18810","pdf_url":null,"source":{"id":"https://openalex.org/S4306401357","display_name":"UTS ePRESS (University of Technology Sydney)","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I114017466","host_organization_name":"University of Technology Sydney","host_organization_lineage":["https://openalex.org/I114017466"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"","raw_type":"Journal Article"}],"best_oa_location":null,"sustainable_development_goals":[{"score":0.5683000087738037,"id":"https://metadata.un.org/sdg/3","display_name":"Good health and well-being"},{"score":0.4943999946117401,"id":"https://metadata.un.org/sdg/9","display_name":"Industry, innovation and infrastructure"}],"sustainable_development_goals_aurora":[{"score":0.46000000834465027,"id":"https://metadata.un.org/sdg/17","display_name":"Partnerships for the goals"}],"study_designs":[],"awards":[],"funders":[],"has_content":{"pdf":false,"grobid_xml":false},"content_urls":null,"referenced_works_count":24,"referenced_works":["https://openalex.org/W27107732","https://openalex.org/W107825094","https://openalex.org/W124370231","https://openalex.org/W187935218","https://openalex.org/W1548055942","https://openalex.org/W1618389625","https://openalex.org/W1895179679","https://openalex.org/W1993985133","https://openalex.org/W1994099082","https://openalex.org/W2012660619","https://openalex.org/W2013536940","https://openalex.org/W2022878945","https://openalex.org/W2038851553","https://openalex.org/W2056230710","https://openalex.org/W2074292818","https://openalex.org/W2101716521","https://openalex.org/W2117928494","https://openalex.org/W2131010646","https://openalex.org/W2140068746","https://openalex.org/W2155636329","https://openalex.org/W2162825290","https://openalex.org/W2169865370","https://openalex.org/W2170555877","https://openalex.org/W3125073388"],"related_works":["https://openalex.org/W2789771233","https://openalex.org/W2942344870","https://openalex.org/W4285891414","https://openalex.org/W1552048504","https://openalex.org/W7124862717","https://openalex.org/W4322757063","https://openalex.org/W153591947","https://openalex.org/W2158127294","https://openalex.org/W2985019900","https://openalex.org/W2086905859"],"abstract_inverted_index":{"Healthcare":[0],"technology":[1,42,238],"is":[2,24,62,150,167,193,199,297],"a":[3,14,25,92,158,219,233,278],"two-edged":[4],"sword":[5],"-":[6,180],"it":[7,178,311],"offers":[8],"new":[9,49,52],"and":[10,118,126,130,206,229,263],"better":[11],"treatment":[12],"to":[13,45,78,165,171,176,186,215,241,260,271,295,301,306],"wider":[15],"range":[16],"of":[17,28,40,94,104,141,189,221,225,232,285,316],"people":[18],"and,":[19],"at":[20],"the":[21,64,75,83,121,135,139,152,213,223,230,253,264,289],"same":[22],"time,":[23],"major":[26],"driver":[27],"increasing":[29],"costs":[30],"in":[31,51,143,266],"health":[32,41,237],"systems.":[33],"Many":[34],"countries":[35],"have":[36,88],"developed":[37],"sophisticated":[38],"systems":[39],"assessment":[43,239],"(HTA)":[44,240],"inform":[46],"decisions":[47,228],"about":[48,195],"investments":[50],"healthcare":[53],"interventions.":[54],"In":[55,73,133],"this":[56,196,246],"paper,":[57],"we":[58,80,146],"question":[59],"whether":[60],"HTA":[61,85,149,269],"also":[63],"appropriate":[65],"framework":[66,154,234,270],"for":[67,107,119,138,291],"guiding":[68],"or":[69,96],"informing":[70],"disinvestment":[71,108,122,156,166,217,227,276,296],"decisions.":[72,309],"exploring":[74],"issues":[76],"related":[77,131],"disinvestment,":[79,145],"first":[81],"discuss":[82],"various":[84],"frameworks":[86],"which":[87,258],"been":[89],"suggested":[90],"as":[91,155,218],"means":[93,103,313],"encouraging":[95],"facilitating":[97],"disinvestment.":[98,243],"We":[99],"then":[100],"describe":[101],"available":[102],"identifying":[105],"candidates":[106],"(comparative":[109],"effectiveness":[110],"research,":[111],"clinical":[112,115],"practice":[113,116],"variations,":[114],"guidelines)":[117],"implementing":[120],"process":[123],"(program":[124],"budgeting":[125],"marginal":[127],"analysis":[128],"(PBMA)":[129],"techniques).":[132],"considering":[134],"possible":[136],"reasons":[137],"lack":[140,224],"progress":[142],"active":[144],"suggest":[147],"that":[148,181,284],"not":[151,168,298],"right":[153],"involves":[157,277],"different":[159,279],"decision":[160,183,280],"making":[161,281],"context.":[162],"The":[163,293],"key":[164,294],"just":[169,299],"what":[170,300],"stop":[172,302],"doing":[173,303],"but":[174,304],"how":[175,305],"make":[177,272],"happen":[179,312],"is,":[182],"makers":[184],"need":[185,214],"be":[187],"aware":[188,315],"funding":[190,317],"disincentives.":[191,318],"What":[192,244,287],"known":[194],"topic?":[197],"Disinvestment":[198],"an":[200,268],"increasingly":[201],"popular":[202],"topic":[203],"amongst":[204],"academics":[205],"policy":[207],"makers.":[208],"Most":[209],"discussions":[210],"focus":[211],"on":[212,236,252],"increase":[216],"corollary":[220],"investment,":[222],"overt":[226],"use":[231],"based":[235],"implement":[242,307],"does":[245],"paper":[247,250],"add?":[248],"This":[249],"focusses":[251],"difficulties":[254],"associated":[255],"with":[256],"deciding":[257],"technologies":[259],"disinvest":[261],"in,":[262],"problems":[265],"using":[267],"such":[273,308],"decisions,":[274],"when":[275],"context":[282],"from":[283],"investment.":[286],"are":[288],"implications":[290],"practitioners?":[292],"Making":[310],"being":[314]},"counts_by_year":[{"year":2025,"cited_by_count":3},{"year":2024,"cited_by_count":6},{"year":2023,"cited_by_count":6},{"year":2022,"cited_by_count":2},{"year":2021,"cited_by_count":10},{"year":2020,"cited_by_count":7},{"year":2019,"cited_by_count":7},{"year":2018,"cited_by_count":4},{"year":2017,"cited_by_count":9},{"year":2016,"cited_by_count":6},{"year":2015,"cited_by_count":5},{"year":2014,"cited_by_count":1},{"year":2013,"cited_by_count":1}],"updated_date":"2026-10-31T12:09:11.096373","created_date":"2016-06-24T00:00:00"}