Providing antibiotics for a viral infection or an infection of the upper respiratory tract are examples of ineffective care practices, according to Sara Ingvarsson, a researcher at the Department of Learning, Informatics, Management and Ethics at Karolinska Institutet in Sweden who recently successfully defended her doctoral thesis on the topic. “It also covers procedures that have an unfavorable risk-benefit ratio, such as performing an unnecessary X-ray examination that exposes the patients to radiation without a need.
There is also a chance of secondary discoveries that are unimportant but disturb the patient regardless.We are unsure. It’s challenging to investigate, and there isn’t much Swedish research on the subject. International estimates, however, indicate that 11 to 30% of all care is provided. In a US survey, 72% of doctors admitted to everyday low-value care delivery.”
“My thesis’ investigations provide a number of justifications. It is a systemic fault, for example, when some regular instructions for sample collection are given even when some are not medically necessary. The doctor-patient connection is another factor. According to the results of my interview research, doctors frequently have a great desire to assist their patients since doing something feels better than doing nothing. Also, it might be challenging to refuse aggressive patients who demand a specific procedure or test. Financial instruments may be challenging.
“It’s human nature to want to help, so it’s easy to understand the doctors’ behavior. But we have a limited healthcare budget and I think it’s important that our shared resources are put to the best possible use.”
“We don’t have an evidence-based method yet. But one way is for care units and medical centers to review their routines so that, for instance, only relevant samples are taken. It’s also important to continue the efforts to reduce the unnecessary prescription of antibiotics. In my experience, doctors are fully aware of the phenomenon, but they might need to raise the issue collectively to make it easier to break certain habits.
At a system level, healthcare organizers should bear in mind that financial incentives can determine the amount of low-value care given. Individual patients also need a better understanding of medical priorities. I believe that few people would demand care if they understood that it would have no effect. But we know too little about the patients’ perspective, and more research is needed.”
