What is low-value care?

Low-value care is care, such as diagnostic and therapeutic interventions, with no or low benefit for the patient. Whether care is of low-value also depends on the patients' preferences.

What are examples of low-value care?

Care providers aim to deliver high quality care for the individual patient. They deliver care based on the best available evidence and their own experiences. Despite this aim, it is known that a part of the delivered care is of low-value. There are many different situations in which care can have no or low benefit for the patient. A few examples:

  • Care that has no benefit in almost all situations, such as routinely shaving of body hair before surgery.
  • Care that is effective for some patients, but not for others. For example, certain forms of chemotherapy.
  • Care that is in essence effective, but used for too long, for example long-term use of antidepressants or a urinary catheter.
  • Care that is used too quickly where watchfull waiting would have been more appropriate because there is a high chance that the complaints dissapear in time, for example a gastroscopy in early stomach complaints.
  • Care that is duplicated or provided less efficiently. For example, a second MRI scan after referral.
  • Care that is in essece effective, but does not fit the individual patient's wishes and preferences, for example knee surgery for a patient that prefers physiotherapy.

Why is low-value care delivered?

Many different factors can play a part in delivering unnecessary care. Among other things, it is difficult for caregivers to determine for which groups of patients and in what situation a health care practice is unnecessary. And even if we know that care is unnecessary, it is often difficult to stop this. This is partly because our care system is focused on 'doing'; Healthcare providers are paid for 'doing' and not for 'doing nothing'. In addition, convincing the patient that a certain care practice is not benficial usually takes more time than a treatment proposal. For caregivers it is sometimes difficult to talk with patients about what is not useful (anymore), especially if patients have high expectations of that practice.