title: Identifying existing health care services that do not provide value for money.
abstract: Health systems can be improved appreciably by making them more efficient and accountable, and enhancing the quality of care, without necessarily requiring additional resources. Australia, like other nations, cannot escape making difficult health care choices in the context of resource scarcity, and the challenge of delivering quality care, informed by best available evidence, to an ageing population with multiple comorbidities. An opportunity exists for a cost-saving or cost-neutral agenda of reallocation of resources within the existing health budget, through reducing the use of existing health care interventions that offer little or no benefit relative to the cost of their public subsidy. This would allow reallocation of funding towards interventions that are more cost-effective, maximising health gain. Criteria based on those developed for health technology assessment (HTA) might facilitate the systematic and transparent identification of existing, potentially ineffective practices on which to prioritise candidates for assessment as to their cost-effectiveness. The process could be jointly funded by all relevant stakeholders but centrally administered, with HTA groups resourced to undertake identification and assessment and to liaise with clinicians, consumers and funding stakeholders.
authors.affiliation: Adelaide Health Technology Assessment, Discipline of Public Health, University of Adelaide, Adelaide, SA, Australia. adam.elshaug@adelaide.edu.au
authors.forename: Adam G
authors.initials: AG
authors.lastname: Elshaug
authors.forename: John R
authors.initials: JR
authors.lastname: Moss
authors.forename: Peter
authors.initials: P
authors.lastname: Littlejohns
authors.forename: Jonathan
authors.initials: J
authors.lastname: Karnon
authors.forename: Tracy L
authors.initials: TL
authors.lastname: Merlin
authors.forename: Janet E
authors.initials: JE
authors.lastname: Hiller
mesh_terms: D001315:Australia; D017046:Cost Savings; D003362:Cost-Benefit Analysis; D003695:Delivery of Health Care / Q000191:economics*; D006801:Humans; D017063:Outcome Assessment, Health Care; D011787:Quality of Health Care / Q000191:economics*; D013673:Technology Assessment, Biomedical