Understanding Physicians’ Perceptions of Overuse of Health Services in Oncology

Ellen, Moriah; Perlman, Saritte; Horowitz, Einav; Shach, Ruth; Catane, Raphael

doi:10.1177/1077558720915112

Cited by 4 publications

(3 citation statements)

References 39 publications

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“…We previously conducted a study interviewing physicians regarding their perceptions of overuse of treatment in cancer. 14 In contrast to the physicians interviewed, nurses discussed palliative care, family involvement, and the facilitating components of the healthcare teams more than physicians. Nurse participants in this study also mentioned the unnecessary use of treatments more frequently than physicians did, which is in line with relevant literature.…”

Section: Discussionmentioning

confidence: 99%

“…In this study, participants discussed clinical examples of unnecessary cancer care in Israel; the related emotional and psychological effects on patients, families, and providers; the negative impact on the health system; facilitators that currently help mitigate unnecessary use; and proposed solutions to further address the issue. We previously conducted a study interviewing physicians regarding their perceptions of overuse of treatment in cancer 14 . In contrast to the physicians interviewed, nurses discussed palliative care, family involvement, and the facilitating components of the healthcare teams more than physicians.…”

Section: Discussionmentioning

confidence: 99%

“…10,11 Other work has explored the perceptions and experiences of nurses in Israel regarding overuse across specialties 12,13 as well as the perceptions of oncologists. 14 However, to date, there has been no parallel work to examine oncology nurses' perspectives regarding overuse within their specialty. This is a vital step in implementing effective health system change to reduce overuse within oncology for several reasons.…”

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confidence: 99%

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Too Much Cancer Care?

2020

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Background “Unnecessary use of health services” refers to care that does not add value for patients and can lead to physical, emotional, and economical harm. High rates of overuse have been reported within oncology, and patients experience its consequences. Objective The aim of this study was to explore perceptions and experiences of oncology nurses regarding unnecessary use of oncology services. Methods In-depth, semistructured interviews were conducted with a convenience sample of 20 oncology nurses currently practicing in Israel. Interviews were recorded, transcribed, and analyzed thematically. Results Themes included perceptions of unnecessary use of health services in cancer (causes and effects of unnecessary use, current and proposed solutions) and negative effects of unnecessary cancer care on patients, families, providers, and the system, including decreased quality of life, increased suffering, and emotional effects on patients and families. Causes were seen on provider, family, and patient levels, such as difficulty for providers to “give up,” lack of registered nurses' authority, and family and patient demands. Multidisciplinary care provision, nurses' role, and the patient-provider relationship were seen as existing facilitators minimizing unnecessary use. Future improvement can be achieved by strengthening relationships, providing support to healthcare providers, and improving communication. Conclusions Nurses perceive unnecessary use of health services as a result of multiple, interlinked and complex causes, but few targeted interventions exist. Future research should explore quantifying unnecessary use to determine an accurate representation of the issue. Implications for Practice Solutions should include engaging patients and families, involving nurses, and fostering multidisciplinary collaborative teamwork to positively affect care and treatment decision-making processes.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Too Much Cancer Care?

2020

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The TRIBE model: How socioemotional processes fuel end-of-life treatment in the United States

Duberstein

Hoerger

Norton

et al. 2023

Social Science & Medicine

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Factors associated with patients’ demand for low-value care: a scoping review

Fraser,

Lambooij,

van Exel

et al. 2024

BMC Health Serv Res

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Background Low-value care is unnecessary care that contributes to inefficient use of health resources and constitutes a considerable proportion of healthcare expenditures worldwide. Factors contributing to patients’ demand for low-value care have often been overlooked and are dispersed in the literature. Therefore, the current study aimed to systematically summarize factors associated with patients’ demand for low-value care. Methods In this scoping review, scientific articles were identified based on a search query conducted in Embase and Scopus. We identified articles using search terms related to low-value care and demand-related factors, published in peer-reviewed journals, and written in English or Dutch. The titles, abstracts, results, and conclusions were inspected to only include articles that were deemed relevant for this topic. From these articles we extracted text fragments that contained factors associated with patients’ demand for low-value care. Hereafter, a thematic analysis was applied to openly, axially, and selectively code textual fragments to identify themes within the data. Results Forty-seven articles were included in this review. We identified eight core themes associated with patients’ demand for low-value care: cognitive biases, emotions, preferences and expectations, knowledge-related factors, socio-cultural factors, biomedical and care-related factors, economic factors, and factors related to the interaction with the healthcare provider. Within these core themes, thirty-three subthemes were identified. For example, risk aversion and anticipated regret aversion are sub-themes of cognitive biases, while consumerism and present and future income effects are sub-themes of economic factors. Conclusions Through this review we provide a systematic overview of factors associated with the demand for low-value care. We found that patients’ demand for low-value care could relate to a multitude of factors that were clustered into eight core themes and thirty-three subthemes. To understand the demand for low-value care from the patient’s perspective in greater detail, future research should focus on the interaction between and importance of these factors in different care contexts.

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Understanding Physicians’ Perceptions of Overuse of Health Services in Oncology

Cited by 4 publications

References 39 publications

Too Much Cancer Care?

Too Much Cancer Care?

The TRIBE model: How socioemotional processes fuel end-of-life treatment in the United States

Factors associated with patients’ demand for low-value care: a scoping review

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