Abstract
Increasing pressure on the healthcare system makes it essential that we use limited resources efficiently. In addition to implementation of (cost-)effective care, de-implementation, the abolishment of ineffective care, is important. In two recent Dutch examples, on de-implementation of back pain care and tonsillectomies/adenotomies, it appears that de-implementation can take up to decades. Based on the literature, we describe facilitators and barriers for de-implementation: personal factors of the practitioner (e.g. knowledge), socio-political (e.g. insured care) factors, factors related to the innovation (e.g. guidelines) and organizational (e.g. healthcare procurement) factors. De-implementation can be accelerated by focusing on these factors; e.g. through further adjustment of compensation systems and improvement of (applicability of) guidelines in combination with (de)implementation activities (such as training and campaigns).
Translated title of the contribution | The implementation of non-effective care - how and why |
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Original language | Dutch |
Journal | Nederlands Tijdschrift voor Geneeskunde |
Volume | 167 |
Publication status | Published - 21 Dec 2023 |
Keywords
- Ethnicity
- Humans
- Pain
- Pressure
- Tonsillectomy