Carolina Moreno-López, Ramon Castano, Pamela Góngora-Salazar, Úrsula Giedion, Ginna P Saavedra, Andrés I Vecino-Ortiz
{"title":"拉丁美洲和加勒比地区的撤资和卫生支出效率：以哥伦比亚为例。","authors":"Carolina Moreno-López, Ramon Castano, Pamela Góngora-Salazar, Úrsula Giedion, Ginna P Saavedra, Andrés I Vecino-Ortiz","doi":"10.1016/j.jval.2025.09.3069","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Health systems in Latin America and the Caribbean (LAC) face financial pressures from rising healthcare costs, inflation, and limited economic growth. Rationalizing inappropriate or unnecessary uses of technologies can enhance efficiency and sustainability, especially when those technologies yield limited benefits or can even lead to potential harm. Strategic disinvestment can contribute to more sustainable health systems by rationalizing spending and improving health outcomes in Latin America and the Caribbean; however, its effects remain largely unexamined in the region.</p><p><strong>Objective: </strong>This study aims to measure and quantify the potential financial and health (opportunity cost) impact of disinvestment in six candidate health technologies in Colombia (cesarean section, preoperative chest x-ray, CT scan for headaches with no warning signs, extended use of proton-pump inhibitors, antibiotics, and antihistamines in cold), identified by previous research.</p><p><strong>Methods: </strong>We carried out a micro-costing approach. involving four steps: identifying required data, defining the baseline case for evaluation, estimating waste for each prioritized technology along with the potential financial impact of disinvestment , and quantifying the opportunity cost of reallocating these resources to selected cost-effective alternatives (best- buys), using different methodologies.</p><p><strong>Results: </strong>Among the six technologies, inappropriate use of CT scans generated the highest level of waste. If reallocated, these resources could enable 9,029 additional women to receive four prenatal care visits, reducing the existing coverage gap by approximately 6.4%. Similar results are presented for other technologies.</p><p><strong>Conclusion: </strong>We showed the potential health effect of redirecting resources from wasteful or ineffective technologies to highly cost-effective interventions offering a practical pathway to narrow coverage gaps and improve health outcomes in the region.</p>","PeriodicalId":23508,"journal":{"name":"Value in Health","volume":" ","pages":""},"PeriodicalIF":6.0000,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Disinvestment and Health Spending Efficiency in Latin America and the Caribbean: A Case Study of Colombia.\",\"authors\":\"Carolina Moreno-López, Ramon Castano, Pamela Góngora-Salazar, Úrsula Giedion, Ginna P Saavedra, Andrés I Vecino-Ortiz\",\"doi\":\"10.1016/j.jval.2025.09.3069\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>Health systems in Latin America and the Caribbean (LAC) face financial pressures from rising healthcare costs, inflation, and limited economic growth. Rationalizing inappropriate or unnecessary uses of technologies can enhance efficiency and sustainability, especially when those technologies yield limited benefits or can even lead to potential harm. Strategic disinvestment can contribute to more sustainable health systems by rationalizing spending and improving health outcomes in Latin America and the Caribbean; however, its effects remain largely unexamined in the region.</p><p><strong>Objective: </strong>This study aims to measure and quantify the potential financial and health (opportunity cost) impact of disinvestment in six candidate health technologies in Colombia (cesarean section, preoperative chest x-ray, CT scan for headaches with no warning signs, extended use of proton-pump inhibitors, antibiotics, and antihistamines in cold), identified by previous research.</p><p><strong>Methods: </strong>We carried out a micro-costing approach. involving four steps: identifying required data, defining the baseline case for evaluation, estimating waste for each prioritized technology along with the potential financial impact of disinvestment , and quantifying the opportunity cost of reallocating these resources to selected cost-effective alternatives (best- buys), using different methodologies.</p><p><strong>Results: </strong>Among the six technologies, inappropriate use of CT scans generated the highest level of waste. If reallocated, these resources could enable 9,029 additional women to receive four prenatal care visits, reducing the existing coverage gap by approximately 6.4%. Similar results are presented for other technologies.</p><p><strong>Conclusion: </strong>We showed the potential health effect of redirecting resources from wasteful or ineffective technologies to highly cost-effective interventions offering a practical pathway to narrow coverage gaps and improve health outcomes in the region.</p>\",\"PeriodicalId\":23508,\"journal\":{\"name\":\"Value in Health\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":6.0000,\"publicationDate\":\"2025-10-21\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Value in Health\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.jval.2025.09.3069\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"ECONOMICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Value in Health","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.jval.2025.09.3069","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ECONOMICS","Score":null,"Total":0}
Disinvestment and Health Spending Efficiency in Latin America and the Caribbean: A Case Study of Colombia.
Introduction: Health systems in Latin America and the Caribbean (LAC) face financial pressures from rising healthcare costs, inflation, and limited economic growth. Rationalizing inappropriate or unnecessary uses of technologies can enhance efficiency and sustainability, especially when those technologies yield limited benefits or can even lead to potential harm. Strategic disinvestment can contribute to more sustainable health systems by rationalizing spending and improving health outcomes in Latin America and the Caribbean; however, its effects remain largely unexamined in the region.
Objective: This study aims to measure and quantify the potential financial and health (opportunity cost) impact of disinvestment in six candidate health technologies in Colombia (cesarean section, preoperative chest x-ray, CT scan for headaches with no warning signs, extended use of proton-pump inhibitors, antibiotics, and antihistamines in cold), identified by previous research.
Methods: We carried out a micro-costing approach. involving four steps: identifying required data, defining the baseline case for evaluation, estimating waste for each prioritized technology along with the potential financial impact of disinvestment , and quantifying the opportunity cost of reallocating these resources to selected cost-effective alternatives (best- buys), using different methodologies.
Results: Among the six technologies, inappropriate use of CT scans generated the highest level of waste. If reallocated, these resources could enable 9,029 additional women to receive four prenatal care visits, reducing the existing coverage gap by approximately 6.4%. Similar results are presented for other technologies.
Conclusion: We showed the potential health effect of redirecting resources from wasteful or ineffective technologies to highly cost-effective interventions offering a practical pathway to narrow coverage gaps and improve health outcomes in the region.
期刊介绍：
Value in Health contains original research articles for pharmacoeconomics, health economics, and outcomes research (clinical, economic, and patient-reported outcomes/preference-based research), as well as conceptual and health policy articles that provide valuable information for health care decision-makers as well as the research community. As the official journal of ISPOR, Value in Health provides a forum for researchers, as well as health care decision-makers to translate outcomes research into health care decisions.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
