Therefore, many patients receive unnecessary care

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What is low value care?

– These are ineffective healthcare interventions, for example taking unnecessary samples, or treatments that don’t help with the current illness, for example antibiotics for viral infections or upper respiratory infections, he says. Sarah Invarsonresearcher in Department of Learning, Informatics, Management and EthicsKarolinska Institutet, who recently defended his doctoral dissertation on low-value care.

This also includes treatments that do not have a balance between risks and benefits. It may include an unwarranted X-ray examination when a patient has been exposed to unnecessary radiation. In addition, there is a risk of side effects that are not harmful but can still cause patient anxiety.

How common is it?

– We don’t know that. It is difficult to investigate and there is a lack of research in the area. But international data reported figures ranging from 11 to 30 percent of the total care provided. In a US survey, 72 percent of physicians answered that they provide low-value care on a daily basis.

Why is this happening?

– Studies in my post show that there are several reasons. It has to do in part with system errors, for example, there may be standard sampling orders where some are not medically justified. But it is also about the doctor-patient relationship. My interview studies show that the doctor often has a strong desire to be able to help the patient and that it is better to do something than nothing. Stubborn patients who want a particular treatment or examination can sometimes be difficult to resist. Financial tools can complicate matters further: If a health center, for example, gets paid for the number of patients it has on file, doctors try to keep patients satisfied. We’ve seen it lead to an increased incidence of low-value care.

Why is it important to pay attention to this?

– It is human to want to do something, so the actions of doctors are easy to understand. But we have a limited healthcare budget and I think it’s important to make the best use of our combined resources.

How can the proportion of low-value care be reduced?

We don’t have an evidence-based method yet. But one way is to review the routines in your care unit so that only relevant samples are taken, for example. It is also important that work continues to reduce unnecessary antibiotic prescribing. My experience is that doctors are well aware of this phenomenon but may need to bring up the problem together to break some behaviors more easily. At the system level, those who regulate sponsorship must bear in mind that financial instruments can influence the occurrence of low-value sponsorship. It is also important that individual patients gain an increased understanding of clinicians’ priorities. I think that few of them would seek treatment if they understood that it had no effect. But we know very little about patients’ perspective, and more research is needed here.

Text: Cecilia Odlind

Publishing

On March 13, 2023, Sarah Ingvarsson defended her doctoral dissertation: Inverting the scale of resources: de-implementing low-value care from an efficient perspective.