ArticleHealth research policy and systems2022
National governance of de-implementation of low-value care: a qualitative study in Sweden.
Article in Health research policy and systems, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
What it found
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it, 13 citations in OpenAlex.
- Effectiveness and mechanisms of interventions to reduce low-value thyroid function tests: a systematic review.Systematic reviews · 2026Pooled it
- Physician-suggested strategies for deimplementing low-value care in Swedish primary care: a qualitative analysis across system levels.Implementation science communications · 2026Article
- Unloading the excess baggage: key informant interviews with Malaysian stakeholders on healthcare disinvestment initiatives.International journal of technology assessment in health care · 2026Article
- Delivering a national de-adoption programme: a documentary analysis of local commissioning policy compliance with England's Evidence-based Interventions programme (EBI).BMC health services research · 2025Article
- Breaking the guidelines: how financial unawareness fuels guideline deviations and inefficient DVT diagnostics.Diagnosis (Berlin, Germany) · 2025Article
- Blending De-implementation and Implementation to Promote Adoption of Universal PrEP Guidelines: Determinants, Strategies, and Outcomes.Critical public health · 2025Article
- Evidence is not enough: health technology reassessment to de-implement low-value care.Health research policy and systems · 2024Article
- Stakeholders' perspectives on disinvestment of low-value healthcare interventions and practices in Malaysia: an online survey.International journal of technology assessment in health care · 2024Article
- A Pragmatic Mapping of Perceptions and Use of Digital Information Systems in Primary Care in Sweden: Survey Study.Interactive journal of medical research · 2023Article
- Low-Value Care: Convergence and Challenges Comment on "Key Factors That Promote Low-Value Care: Views From Experts From the United States, Canada, and the Netherlands".International journal of health policy and management · 2022Article
Corrections and comments
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Authors and funding
9 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundThe de-implementation of low-value care (LVC) is important to improving patient and population health, minimizing patient harm and reducing resource waste. However, there is limited knowledge about how the de-implementation of LVC is governed and what challenges might be involved. In this study, we aimed to (1) identify key stakeholders' activities in relation to de-implementing LVC in Sweden at the national governance level and (2) identify challenges involved in the national governance of the de-implementation of LVC.
methodsWe used a purposeful sampling strategy to identify stakeholders in Sweden having a potential role in governing the de-implementation of LVC at a national level. Twelve informants from nine stakeholder agencies/organizations were recruited using snowball sampling. Semi-structured interviews were conducted, transcribed and analysed using inductive thematic analysis.
resultsFour potential activities for governing the de-implementation of LVC at a national level were identified: recommendations, health technology assessment, control over pharmaceutical products and a national system for knowledge management. Challenges involved included various vested interests that result in the maintenance of LVC and a low overall priority of working with the de-implementation of LVC compared with the implementation of new evidence. Ambiguous evidence made it difficult to clearly determine whether a practice was LVC. Unclear roles, where none of the stakeholders perceived that they had a formal mandate to govern the de-implementation of LVC, further contributed to the challenges involved in governing that de-implementation.
conclusionsVarious activities were performed to govern the de-implementation of LVC at a national level in Sweden; however, these were limited and had a lower priority relative to the implementation of new methods. Challenges involved relate to unfavourable change incentives, ambiguous evidence, and unclear roles to govern the de-implementation of LVC. Addressing these challenges could make the national-level governance of de-implementation more systematic and thereby help create favourable conditions for reducing LVC in healthcare.
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Registered trials
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