NDLI: Evidence is not enough: health technology reassessment to de-implement low-value care

Content Provider	Springer Nature : BioMed Central
Author	Ingvarsson, Sara Hasson, Henna von Thiele Schwarz, Ulrica Nilsen, Per Roczniewska, Marta Augustsson, Hanna
Abstract	Background The use of low-value care (LVC) is a persistent challenge in health care. Health technology reassessment (HTR) assesses the effects of technologies currently used in the health care system to guide optimal use of these technologies. Consequently, HTR holds promises for identifying and reducing, i.e., de-implementing, the use of LVC. There is limited research on how HTR is executed to support the de-implementation of LVC and whether and how HTR outcomes are translated into practical application. The aim of this study is to investigate how HTR is conducted to facilitate de-implementation of LVC and to investigate how the results of HTR are received and acted on in health care settings. Methods This study is a qualitative interview study with representatives from health technology assessment agencies (n = 16) that support the regional health care organizations in Sweden and with representatives from the health care organizations (n = 7). Interviews were analysed with qualitative content analysis. Results We identified three overarching categories for how HTR facilitates de-implementation of LVC and how the results are received and acted on in health care settings: (1) involving key stakeholders to facilitate de-implementation of LVC in identifying potential LVC practices, having criteria for accepting HTR targets, ascertaining high-quality reports and disseminating the reports; (2) actions taken by health care organization to de-implement LVC by priority setting and decision-making, networking between health care organizations and monitoring changes in the use of LVC practices; and (3) sustaining use of LVC by not questioning continued use, continued funding of LVC and by creating opinion against de-implementation. Conclusions Evidence is not enough to achieve de-implementation of LVC. This has made health technology assessment agencies and health care organizations widen the scope of HTR to encompass strategies to facilitate de-implementation, including involving key stakeholders in the HTR process and taking actions to support de-implementation. Despite these efforts, there can still be resistance to de-implementation of LVC in passive forms, involving continued use of the practice and more active resistance such as continued funding and opinion-making opposing de-implementation. Knowledge from implementation and de-implementation research can offer guidance in how to support the execution phase of HTR.
Related Links	https://health-policy-systems.biomedcentral.com/counter/pdf/10.1186/s12961-024-01249-w.pdf
Ending Page	12
Page Count	12
Starting Page	1
File Format	HTM / HTML
ISSN	14784505
DOI	10.1186/s12961-024-01249-w
Journal	Health Research Policy and Systems
Issue Number	1
Volume Number	22
Language	English
Publisher	BioMed Central
Publisher Date	2024-12-03
Access Restriction	Open
Subject Keyword	Health Administration R & D Technology Policy Medicine Public Health Health Services Research Health Policy Low-value care De-implementation Health technology assessment Overuse Disinvestment Health care governance R & D/Technology Policy Medicine/Public Health
Content Type	Text
Resource Type	Article
Subject	Health Policy
Journal Impact Factor	3.6/2023
5-Year Journal Impact Factor	4.3/2023

Sl.	Authority	Responsibilities	Communication Details
1	Ministry of Education (GoI), Department of Higher Education	Sanctioning Authority	https://www.education.gov.in/ict-initiatives
2	Indian Institute of Technology Kharagpur	Host Institute of the Project: The host institute of the project is responsible for providing infrastructure support and hosting the project	https://www.iitkgp.ac.in
3	National Digital Library of India Office, Indian Institute of Technology Kharagpur	The administrative and infrastructural headquarters of the project	Dr. B. Sutradhar bsutra@ndl.gov.in
4	Project PI / Joint PI	Principal Investigator and Joint Principal Investigators of the project	Dr. B. Sutradhar bsutra@ndl.gov.in Prof. Saswat Chakrabarti will be added soon
5	Website/Portal (Helpdesk)	Queries regarding NDLI and its services	support@ndl.gov.in
6	Contents and Copyright Issues	Queries related to content curation and copyright issues	content@ndl.gov.in
7	National Digital Library of India Club (NDLI Club)	Queries related to NDLI Club formation, support, user awareness program, seminar/symposium, collaboration, social media, promotion, and outreach	clubsupport@ndl.gov.in
8	Digital Preservation Centre (DPC)	Assistance with digitizing and archiving copyright-free printed books	dpc@ndl.gov.in
9	IDR Setup or Support	Queries related to establishment and support of Institutional Digital Repository (IDR) and IDR workshops	idr@ndl.gov.in

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