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• W4285664159 abstract "Abstract Background The use of low-value care (LVC) is widespread and has an impact on both the use of resources and quality of care. However, few studies have thus far studied the factors influencing the use of LVC from the perspective of the practitioners themselves. The aim of this study is to understand why physicians within primary care use LVC. Methods Six primary health care centers in the Stockholm Region were purposively selected based on their level of prescription of three low-value lab tests (e.g., erythrocyte sedimentation rate, aspartate transaminase, vitamin D). FGDs were conducted with physicians (n = 31) working in the centers. The discussions were coded inductively using a grounded theory approach. Results Three main reasons for performing LVC were identified. Uncertainty and disagreement about what not to do was related to being unaware of the LVC status of a practice, guidelines perceived as conflicting, guidelines perceived to be irrelevant for the target patient population, or a lack of trust in the guidelines. Perceived pressure from others concerned patient pressure, pressure from other physicians, or pressure from the health care system. A desire to do something for the patients was associated with the fact that the visit in itself prompts action, symptoms to relieve, or emotions to calm. The three reasons are interdependent. Uncertainty and disagreement about what not to do have made it more difficult to handle the pressure from others and to refrain from doing something for the patients. The pressure from others and the desire to do something for the patients enhanced the uncertainty and disagreement about what not to do. Furthermore, the pressure from others influenced the desire to do something for the patients. Conclusions Three reasons work together to explain primary care physicians’ use of LVC: uncertainty and disagreement about what not to do, perceived pressure from others, and the desire to do something for the patients. The reasons may, in turn, be influenced by the health care system, but the decision nevertheless seemed to be up to the individual physician. The findings suggest that the de-implementation of LVC needs to address the three reasons from a systems perspective." @default.
• W4285664159 created "2022-07-17" @default.
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• W4285664159 date "2020-07-23" @default.
• W4285664159 modified "2023-10-03" @default.
• W4285664159 title "Why Do They Do It? A Grounded Theory Study of the Use of Low-value Care Among Primary Health Care Physicians" @default.
• W4285664159 doi "https://doi.org/10.21203/rs.3.rs-44049/v1" @default.
• W4285664159 hasPublicationYear "2020" @default.
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