Deimplement low-value practices: an ethical imperative

Authors

  • Karin Kopitowski Departamento de Investigación. Instituto Universitario Hospital Italiano de Buenos Aires. Buenos Aires, Argentina

DOI:

https://doi.org/10.51987/revhospitalbaires.v42i4.228

Keywords:

low value care, overuse, patient safety

Abstract

Health care must be sustainable. One of the aspects that undermine sustainability is the provision of low-value care. We must stop these practices because they waste resources, put patients at risk, and harm the planet. It seems that focusing on the fact that low-value care constitutes a safety problem would be adequate to favor its deimplementation.

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References

OECD. Tackling wasteful spending on health. Paris: OECD; 2017. https://doi.org/10.1787/9789264266414-en. DOI: https://doi.org/10.1787/9789264266414-en

Welch HG, Schwartz L, Woloshin S. Overdiagnosed: making people sick in the pursuit of health. Boston: Beacon Press, 2011.

Cotter AR, Vuong K, Mustelin L, et al. Do psychological harms result from being labelled with an unexpected diagnosis of abdominal aortic aneurysm or prostate cancer through screening? A systematic review. BMJ Open. 2017;7(12):e017565. https://doi.org/10.1136/bmjopen-2017-017565 Errata en: BMJ Open. 2018;8(1):e017565corr1. https://doi.org/10.1136/bmjopen-2017-017565corr1. DOI: https://doi.org/10.1136/bmjopen-2017-017565corr1

May C, Montori VM, Mair FS. We need minimally disruptive medicine. BMJ. 2009;339:b2803. https://doi.org/10.1136/bmj.b2803. DOI: https://doi.org/10.1136/bmj.b2803

Glasziou P, Straus S, Brownlee S, et al. Evidence for underuse of effective medical services around the world. Lancet. 2017;390(10090):169-177. https://doi.org/10.1016/S0140-6736(16)30946-1. DOI: https://doi.org/10.1016/S0140-6736(16)30946-1

Porter J, Boyd C, Skandari MR, et al. Revisiting the time needed to provide adult primary care. J Gen Intern Med. 2022 Jul 1. En prensa. https://doi.org/10.1007/s11606-022-07707-x. DOI: https://doi.org/10.1007/s11606-022-07707-x

Petursson H, Getz L, Sigurdsson JA, et al. Current European guidelines for management of arterial hypertension: are they adequate for use in primary care? Modelling study based on the Norwegian HUNT 2 population. BMC Fam Pract. 2009;10:70. https://doi.org/10.1186/1471-2296-10-70. DOI: https://doi.org/10.1186/1471-2296-10-70

West CP, Dyrbye LN, Shanafelt TD. Physician burnout: contributors, consequences and solutions. J Intern Med. 2018;283(6):516-529. https://doi.org/10.1111/joim.12752. DOI: https://doi.org/10.1111/joim.12752

Montori V. Why we revolt: a patient revolution for careful and kind care. 2nd ed. Rochester, MN: Mayo Clinic Press; 2020.

OECD. Fiscal sustainability of health systems: bridging health and finance perspectives. Paris: OECD; 2015. https://doi.org/10.1787/9789264233386-en. DOI: https://doi.org/10.1787/9789264233386-en

Marmot M, Allen J, Bell R, et al. WHO European review of social determinants of health and the health divide. Lancet. 2012;380(9846):1011-1129. https://doi.org/10.1016/S0140-6736(12)61228-8. DOI: https://doi.org/10.1016/S0140-6736(12)61228-8

Barratt A, McGain F. Overdiagnosis is increasing the carbon footprint of healthcare. BMJ. 2021;375:n2407. https://doi.org/10.1136/bmj.n2407. DOI: https://doi.org/10.1136/bmj.n2407

MacLeod S, Musich S, Hawkins K, et al. Highlighting a common quality of care delivery problem: overuse of low-value healthcare services. J Healthc Qual. 2018;40(4):201-208. https://doi.org/10.1097/JHQ.0000000000000095 DOI: https://doi.org/10.1097/JHQ.0000000000000095

Hicks LK. Reframing overuse in health care: time to focus on the harms. J Oncol Pract. 2015;11(3):168-170. https://doi.org/10.1200/JOP.2015.004283. DOI: https://doi.org/10.1200/JOP.2015.004283

Caughey GE, Tait K, Vitry AI, et al. Influence of medication risks and benefits on treatment preferences in older patients with multimorbidity. Patient Prefer Adherence. 2017;11:131-140. https://doi.org/10.2147/PPA.S118836. DOI: https://doi.org/10.2147/PPA.S118836

Coon ER, Newman TB, Hall M, et al. Trends in imaging findings, interventions, and outcomes among children with isolated head trauma. Pediatr Emerg Care. 2021;37(2):55-61. https://doi.org/10.1097/PEC.0000000000001475. DOI: https://doi.org/10.1097/PEC.0000000000001475

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Published

2022-12-29

How to Cite

1.
Kopitowski K. Deimplement low-value practices: an ethical imperative. Rev Hosp Ital B.Aires [Internet]. 2022 Dec. 29 [cited 2026 Aug. 21];42(4):p. 196-197. Available from: https://ojs.hospitalitaliano.org.ar/index.php/revistahi/article/view/228