Table 8 Identified determinants for the use of LVC and de-implementation of LVC
From: Determinants for the use and de-implementation of low-value care in health care: a scoping review
Studies on determinants for LVC use total n = 92 | Studies on determinants for de-implementation total n = 9 | |||||
|---|---|---|---|---|---|---|
Determinants | Total no of studies including the determinant | No (%) of studies linking the determinant to LVC use | No (%) of studies linking the determinant to low LVC use | Total no of studies including the determinant | No (%) of studies with the determinant as a facilitator of de-implementation | No (%) of studies with the determinant as a barrier to de-implementation |
Patient determinants | ||||||
 Patient characteristics | 39 | 37 (94.9) | 10 (25.6) | - |  |  |
 Patient health condition | 19 | 17 (89.5) | 2 (10.5) | - |  |  |
 Patient expectations | 16 | 16 (100) |  | 5 |  | 5 (100) |
 Patient knowledge | - |  |  | 2 | 1 (50.0) | 1 (50.0) |
 Expectations from relatives | 2 | 2 (100) |  | - |  |  |
Professional determinants | ||||||
 Professional characteristics | 28 | 24 (85.7) | 7 (25.0) | - |  |  |
 Professional knowledge of LVC | 9 | 6 (66.7) | 3 (33.4) | 1 |  | 1 (100) |
 Professionals’ expectations, attitudes and behaviours | 18 | 17 (94.4) | 2 (11.1) | 5 |  | 5 (100) |
 Professionals' memory | - |  |  | 1 |  | 1 (100) |
Outer context determinants | ||||||
 Location | 14 | 13 (92.9) | 5 (35.7) | - |  |  |
 Economy | 15 | 13 (86.7) | 4 (26.7) | 1 |  | 1 (100) |
 Outer context characteristics | 7 | 4 (71.4) | 3 (42.9) | - |  |  |
 Patient volume | 4 | 4 (100) |  | - |  |  |
 Policy and political support | 3 | 1 (33.4) | 2 (66.7) | 3 | 2 (66.7) | 1 (33.4) |
 Marketing | 3 | 3 (100) |  | - |  |  |
 Time | 4 | 4 (100) |  | - |  |  |
 Pressure from suppliers | - |  |  | 1 | 1 (100) |  |
Inner context determinants | ||||||
 Setting characteristics | 19 | 15 (78.9) | 6 (31.6) | 1 | 1 (100) |  |
 Work/care process | 20 | 18 (90.0) | 4 (20.0) | 3 |  | 3 (100) |
 Staff composition | 3 | 3 (100) |  | - |  |  |
 Organisational structures related to the LVC | 5 | 5 (100) |  | - |  |  |
 Interaction between professionals | 4 | 4 (100) |  | 1 |  | 1 (100) |
 Culture | 3 | 3 (100) |  | 1 | 1 (100) |  |
 Patient-provider communication/interaction | 2 | 2 (100) |  | - |  |  |
Process determinants | ||||||
 Strategies | 4 |  | 4 (100) | - |  |  |
 De-implementation process | - |  |  | 2 | 1 (50.0) | 1 (50.0) |
Evidence and LVC practice determinants | ||||||
 Evidence | 7 | 7 (100) |  | 1 |  | 1 (100) |
 Characteristics of the LVC | 2 | 2 (100) |  | - |  |  |
 Negative consequences of reducing LVC for the professional | - |  |  | 1 |  | 1 (100) |
 Characteristics of alternative practice | 2 | 2 (100) |  | 1 |  | 1 (100) |
Othera | 3 | 3 (100) | Â | - | Â | Â |