{
  "abstract": "Low-value care (LVC) refers to practices that provide little or no benefit and have the potential to cause harm and incur unnecessary costs for patients and the system.In recent years, there has been growing interest in limiting their use within the health system. There is little information in the literature about the perspective of people who hold management positions in the health system regarding LVC. Knowing the perspective of these actors allows us to obtain valuable information that can facilitate the de-implementation of these practices.Objectives Identify the thoughts, beliefs and attitudes regarding CBV and their deimplementation, of people who occupy management roles in a private health insurance company.Method Qualitative analysis of the transcription of ten semi-structured interviews with intentional sampling.Results Four thematic categories were identified: Concept of LVCC: The interviewees recognized the term but pointed out its ambiguity when applying it. Obstacles to implementation: Erroneous beliefs of physicians influenced by professional habits and outdated medical education, biased use of scientific evidence (‘cherry picking’), economic incentives derived from the payment-for-service model, social and professional culture that assumes that ‘more is better’, overvaluation of expensive technologies compared to resource-intensive human practices, imprecise government regulations and a fragmented health system. Institutional strengths and external factors: The inclusion of CBEV in the hospital’s strategic plan, the vertical integration of the system and the generational renewal of managers were mentioned as facilitating factors for this purpose. Strategies to implement CBEV: Clinical homogenization; monitoring and auditing and value-linked payment; incorporating measures based on experience and patient-reported outcomes.Conclusions The de-implementation of VDCs is a complex task, but strengths and opportunities could facilitate the transition to a value-based model. However, cultural, economic, and regulatory barriers represent significant challenges. Educational, auditing, and policy components that link economic incentives to the value of practices are proposed strategies.",
  "authors": [
    {
      "affiliations": [
        "Hospital Italiano de Buenos Aires, Capital federal, Argentina"
      ],
      "name": "Julieta Bitler"
    },
    {
      "affiliations": [
        "Hospital Italiano de Buenos Aires, Capital federal, Argentina"
      ],
      "name": "Sebastian Sguiglia Schutz"
    },
    {
      "affiliations": [
        "Hospital Italiano de Buenos Aires, Capital federal, Argentina"
      ],
      "name": "Dolores Arceo"
    },
    {
      "affiliations": [
        "Hospital Italiano de Buenos Aires, Capital federal, Argentina"
      ],
      "name": "Sergio Adrian Terrasa"
    },
    {
      "affiliations": [
        "Hospital Italiano de Buenos Aires, Capital federal, Argentina"
      ],
      "name": "Mariela Weisbrot"
    },
    {
      "affiliations": [
        "Hospital Italiano de Buenos Aires, Capital federal, Argentina"
      ],
      "name": "Santiago Esteban"
    }
  ],
  "title": "026 Low value care (LVC) and its deimplementation at the Italian’s hospital of buenos aires (HIBA)",
  "uid": "1a6ec35a-8b8e-58ba-9833-a77ee32c1ad4"
}