Department of IQ Healthcare, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, the Netherlands.
Department of Medical Specialist Care, Netherlands Patients Federation, Utrecht, the Netherlands.
Patient Educ Couns. 2023 Jun;111:107687. doi: 10.1016/j.pec.2023.107687. Epub 2023 Mar 5.
Clinicians consider patients' expectations and demands as a major driver of low-value care. However, little is known about the patients' perspective. We aimed to explore patients' perceptions of low-value care.
We performed semi-structured interviews with 24 patients from the Netherlands and explored their ideas of and experiences with low-value care, and their perception of its consequences and solutions. The interviews were analysed using inductive thematic analysis.
Patients considered several types of care to be of low value, such as duplicate care, care that does not fit their preferences, inefficient care, and care that could have been prevented. The main causes of low-value care according to patients are poor clinician-patient communication and adhering to protocols instead of tailoring care to the individual patient. Consequences of low-value care were a burden for the patient, higher healthcare costs, and less room for high-value care.
Patients' view of low-value care extends beyond care that is medically ineffective. Their experiences could help to identify opportunities to reduce the (perceived) use of low-value care.
Future de-implementation studies could benefit from engaging patients. Dutch patients understand the importance of reducing low-value care and could be strong advocates for de-implementation programs.
临床医生认为患者的期望和需求是低价值医疗的主要驱动因素。然而，人们对患者的观点知之甚少。我们旨在探讨患者对低价值医疗的看法。
我们对来自荷兰的 24 名患者进行了半结构化访谈，探讨了他们对低价值医疗的看法和体验，以及对其后果和解决方案的看法。使用归纳主题分析对访谈进行分析。
患者认为几种类型的医疗属于低价值，例如重复医疗、不符合患者偏好的医疗、效率低下的医疗以及本可预防的医疗。根据患者的说法，低价值医疗的主要原因是临床医生与患者之间沟通不畅以及坚持遵循协议而不是根据个体患者的情况定制医疗方案。低价值医疗的后果是给患者带来负担、增加医疗保健成本和减少高价值医疗的空间。
患者对低价值医疗的看法超出了医疗无效的范围。他们的经验可以帮助确定减少（感知到的）低价值医疗的机会。
未来的去实施研究可以从让患者参与中受益。荷兰患者理解减少低价值医疗的重要性，并且可以成为去实施计划的有力倡导者。
