To what extent do citizens support the disinvestment of healthcare interventions? An exploration of the support for four viewpoints on active disinvestment in the Netherlands

Adriënne H. Rotteveel*, Mattijs S. Lambooij, Job van Exel, G. Ardine de Wit

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Abstract

Background: Active disinvestment of healthcare interventions (i.e. discontinuing reimbursement by means of a policy decision) has received limited public support in the past. Previous research has identified four viewpoints on active disinvestment among citizens in the Netherlands. However, it remained unclear how strong these viewpoints are supported by society, and by whom. Therefore, the current study aimed to 1) measure the support for these four viewpoints and 2) assess whether support is associated with background characteristics of citizens. Method: In an online survey, a representative sample of adult citizens in the Netherlands (n = 1794) was asked to rate their agreement with short narratives of the four viewpoints on a 7-point Likert scale. The survey also included questions on sociodemographic characteristics, health status, healthcare utilization, and opinions about responsibility and costs in the healthcare context. Logistic regression models were estimated for each viewpoint to assess the association between viewpoint support and these characteristics. Results: The support for the different viewpoints varied between 46.8% and 57.7% of the sample. Viewpoint support was associated with participants’ age, gender, educational level, financial situation, healthcare utilization, opinion on the responsibility of the government for the health of citizens, and opinion on whether the increase in healthcare expenditure and health insurance premiums is considered a problem. Conclusion: Resistance to active disinvestment may partially be explained by the consequences of disinvestment citizens anticipate experiencing themselves. Citizens considering the increase in healthcare expenditure a larger problem were more supportive of disinvestment than those considering it less of a problem.

Original languageEnglish
Article number114662
JournalSocial Science and Medicine
Volume293
Early online date17 Dec 2021
DOIs
Publication statusPublished - Jan 2022

Bibliographical note

Funding Information:
This research was funded by the strategic research programme RIVM (S/133005), a research fund from the National Institute of Public Health and the Environment, the Netherlands. Funders had no role in the design of the study, its conduct, or the analysis of the results and were not involved in manuscript preparation or submission.

Publisher Copyright:
© 2021 The Authors

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