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Commentary
Context, Culture, and the Complexity of De-Implementing Low-Value Care Comment on “Key Factors that Promote Low-Value Care: Views of Experts From the United States, Canada, and the Netherlands”
Emma E. Sypes
1 
, Jeanna Parsons Leigh
2,3,4,5, Henry T. Stelfox
3,4,5* , Daniel J. Niven
3,4,51 Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.
2 School of Health Administration, Faculty of Health, Dalhousie University, Halifax, NS, Canada.
3 Department of Critical Care Medicine, University of Calgary and Alberta Health Services, Calgary, AB, Canada.
4 Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada.
5 O’Brien Institute for Public Health, University of Calgary, Calgary, AB, Canada.
Abstract
Low-value care contributes to poor quality of care and wasteful spending in healthcare systems. In Verkerk and colleagues’ recent qualitative study, interviews with low-value care experts from Canada, the United States, and the Netherlands identified a broad range of nationally relevant social, system, and knowledge factors that promote ongoing use of low-value care. These factors highlight the complexity of the problem that is persistent use of low-value care and how it is heavily influenced by public and medical culture as well as healthcare system features. This commentary discusses how these findings integrate within current low-value care and de-implementation literature and uses specific low-value care examples to highlight the importance of considering context, culture, and clinical setting when considering how to apply these factors to future de-implementation initiatives.
Citation: Sypes EE, Leigh JP, Stelfox HT, Niven DJ. Context, culture, and the complexity of de-implementing low-value care: Comment on “Key factors that promote low-value care: views of experts from the United States, Canada, and the Netherlands.” Int J Health Policy Manag. 2022;11(8):1592–1594. doi:10.34172/ijhpm.2022.6968