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[1]ZHANG Xiaoran,ZHANG Chuxuan,RU Nan.Meta-Synthesis of Qualitative Studies on Patients’ Perceptions of Low-Value Healthcare[J].Chinese Health Quality Management,2026,33(3):41-46.[doi:10.13912/j.cnki.chqm.2026.33.3.10]

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Meta-Synthesis of Qualitative Studies on Patients’ Perceptions of Low-Value Healthcare

Chinese Health Quality Management[ISSN 1006-7515/CN CN 61-1283/R] Volume: 33 Number of periods: 2026年3期 Page number: 41-46 Column: 医疗质量 Public date: 2026-03-15

Title:: Meta-Synthesis of Qualitative Studies on Patients’ Perceptions of Low-Value Healthcare

Author(s):: ZHANG Xiaoran; ZHANG Chuxuan; RU Nan; Capital Medical University School of Nursing

Keywords:: Low-Value Healthcare; Patient Perception; Qualitative Research; Meta-Synthesis

CLC:: R197.323

DOI:: 10.13912/j.cnki.chqm.2026.33.3.10

Abstract:: ObjectiveTo integrate patients’ perceptions of low-value healthcare and provide references for reducing low-value healthcare services.MethodsA computerized search was conducted in Chinese and English databases for qualitative studies on patients’ perceptions of low-value healthcare, covering the period from the establishment of the databases to December 2024. A convergent Meta-synthesis approach was employed to integrate the findings.ResultsA total of 10 studies were included, from which 40 findings were extracted and categorized into 10 classes, ultimately integrated into three main results: patients’ understanding and attitudes toward low-value healthcare, including the perception that premature interventions and those inconsistent with personal preferences constitute low-value healthcare, as well as differing perceptions and attitudes toward diagnostic tests and treatment procedures within low-value healthcare; the causes of low-value healthcare from patients’ perspectives, encompassing the desire to eliminate uncertainty about diseases, the belief that more healthcare services are better, healthcare providers’ lack of understanding of patients’ treatment preferences, redundant tests, and the perception that doctors are incentivized by pharmaceutical companies to prescribe irrationally; and patients’ suggestions for reducing low-value healthcare, including acquiring more knowledge about low-value healthcare, shared decision-making between doctors and patients, and enhanced regulatory oversight by relevant departments. Conclusion Patients’ understanding of low-value healthcare is partial, and the causes of low-value healthcare from their perspective involve multiple internal and external factors. A comprehensive approach is expected to reduce low-value healthcare. In the future, measures such as strengthening patient education on low-value healthcare, promoting shared decision-making between doctors and patients, and enhancing government regulatory functions should be implemented to reduce low-value healthcare services.

References:: ［1］KIM DD,DO LA,DALY AT,et al.An evidence review of low-value care recommendations: inconsistency and lack of economic evidence considered［J］.J Gen Intern Med, 2021,36(11):3448-3455.［2］茹楠,贾香平,关瑜山,等.助推策略对低价值医疗行为干预效果的Meta分析［J］.中国卫生质量管理,2024,31(11):30-34,51.［3］BERWICK DM, HACKBARTH AD.Eliminating waste in US health care［J］.JAMA,2012, 307(14):1513-1516.［4］BADGERY-PARKER T,PEARSON SA,DUNN S,et al.Measuring hospital-acquired complications associated with low-value care［J］. JAMA Intern Med,2019,179(4):499-505.［5］LEVINSON W,KALLEWAARD M,BHATIA RS,et al.‘Choosing Wisely’:a growing international campaign［J］.BMJ Qual Saf,2015,24(2):167-174.［6］BARON RJ,WOLFSON DB.Ten years of choosing wisely to reduce low-value care［J］. N Engl J Med,2022,386(25): 2443.［7］关瑜山,茹楠,贾香平,等. DRG背景下低价值医疗的研究进展与启示［J］.卫生经济研究, 2024,41(2):10-13,18. ［8］胡雁.如何开展质性研究的系统评价和Meta整合［J］.上海护理,2020,20(7):1-5.［9］Joanna Briggs Institute.Critical appraisal tools［EB/OL］.［2025-07-30］. https://jbi.global/critical-appraisal-tools.［10］TRELOAR C,CHAMPNESS S,SIMPSON PL,et al.Critical appraisal checklist for qualitative research studies［J］.Indian J Pediatr,2000,67(5):347-351.［11］SCHLEIFER D,ROTHMAN DJ. "The ultimate decision is yours":exploring patients’ attitudes about the overuse of medical interventions［J］.PLoS ONE,2012,7(12): e52552.［12］HERSCH J,JANSEN J,BARRATT A,et al.Women’s views on overdiagnosis in breast cancer screening: a qualitative study［J］.The BMJ,2013,346: 158.［13］WALLER J,DOUGLAS E,WHITAKER KL,et al.Women’s responses to information about overdiagnosis in the UK breast cancer screening programme: a qualitative study［J］.BMJ Open,2013, 3(4): e002703.［14］SUTKOWI-HEMSTREET A,VU M,HARRIS R,et al.Adult patients’ perspectives on the benefits and harms of overused screening tests: a qualitative study［J］.J Gen Intern Med,2015,30(11): 1618-1626.［15］GREEN AR,TUNG M,SEGAL JB.Older adults’ perceptions of the causes and consequences of healthcare overuse:a qualitative study［J］.J Gen Intern Med,2018,33(6):892-897.［16］HERWIG A,DEHNEN D,WELTERMANN B.Patient factors driving overuse of cardiac catheterisation:a qualitative study with 25 participants from two German teaching practices［J］.BMJ Open,2019,9(4):e024600.［17］WANG T,MOTT N,MILLER J,et al.Patient perspectives on treatment options for older women with hormone receptor-positive breast cancer［J］.JAMA Netw Open,2020,3(9):e2017129.［18］VERKERK EW,BOEKKOOI JAH,PELS EGM,et al.Exploring patients’ perceptions of low-value care:an interview study［J］.Patient Educ Couns,2023,111:107687.［19］BARBOSA MM,DOS SANTOS AJM,GALLI N,et al.Perceptions of medical doctors and patients about imaging for people with low back pain:a qualitative study［J］.PM R,2024,16(12):1317-1323.［20］SEBASTIAO M,PESCH J,KUHLEIN T,et al.’The health care system is more like a business’—medical overuse from the patients’ perspective in Germany: a qualitative study［J］.BMJ Open,2024,14(7): e084065.［21］VOLPP KG,LOEWENSTEIN G,ASCH D.Choosing Wisely: low value services, utilization, and patient cost sharing［J］. JAMA,2012,308(16):1635-1636.［22］DE GROOD C,SYPES EE,NIVEN DJ,et al.Patient and family involvement in Choosing Wisely initiatives: a mixed methods study［J］. BMC Health Serv Res, 2022,22(1):457.［23］ELSHAUG AG,HILLER JE,TUNIS SR,et al.Challenges in Australian policy processes for disinvestment from existing,ineffective health care practices［J］.Aust New Zealand Health Policy,2007, 4:23.［24］BOCK LA,NOBEN CYG,HAEREN RHL,et al.Unravelling low-value care decision-making: residents’ perspectives on the influence of contextual factors［J］.Int J Health Policy Manag,2024,13: 7907.［25］NORTON WE,CHAMBERS DA.Unpacking the complexities of de-implementing inappropriate health interventions［J］.Implement Sci,2020,15(1):2.［26］ALLEN J,KING R,GOERGEN SK,et al.Semistructured interviews regarding patients’ perceptions of Choosing Wisely and shared decision-making: an Australian study［J］.BMJ Open,2019,9(8):e031831.［27］何桂香,刘金宝,冯爱国,等.患者视角下的不良医疗行为认知分析［J］.卫生软科学, 2013, 27(6):374-377.［28］侯慧玉,张少华,田溢卿,等.DIP改革背景下负向医疗行为成因及治理策略分析［J］.医学与哲学,2024,45(14):28-31.［29］樊宏,周颖,张猛,等.患者过度医疗相关知识认知度调查［J］.中国社会医学杂志,2014, 31(2):92-94.［30］于梦根,魏景明,任苒.患者对过度医疗的认知与行为调查分析［J］.医学与哲学(A),2018, 39(A):81-84.［31］朱清,彭兰雅,彭一,等.医务人员医患沟通能力及防御性医疗行为影响因素的结构方程模型研究［J］.中国卫生质量管理, 2023, 30(1): 56-61.

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Last Update: 2026-03-15