Thailand’s health system is facing challenges from resource constraints including limited budgets, shortages of health professionals, and restricted access to essential medical equipment. At the same time, the system continues to provide low-value care (LVC), which not only fails to deliver meaningful benefits to patients but also results in potentially wasteful use of scarce resources. This study aimed to: 1) identify and classify medical
procedures or interventions that may be considered LVC in the Thai context; 2) explore healthcare providers’ perspectives and experiences regarding LVC; and 3) validate specified potential LVC procedures through expert consultations while assessing their potential impact on the health system.
The study employed three main methods: 1) a rapid review of international and national literature for definitions and lists of services categorized as LVC; 2) an online survey among healthcare professionals, medical royal colleges, and health insurance funders to identify potential LVC procedures and to assess perceptions and experiences related to LVC; and 3) expert consultation discussions to validate the potential LVC services in the Thai context.
The results identified a working definition of LVC applicable to Thailand and compiled 583 potential LVC procedures and interventions from the literature review and survey. After screening and prioritization process in collaboration with the LVC Working Group under the National Health Security Office, 23 items were shortlisted for in-depth investigations such as preoperative echocardiography and colonoscopy. Additionally, a total of 155 healthcare professionals responded to the survey and 82% considered LVC a problem in the health system although most perceived it as not severe. Many respondents reported either observing or occasionally providing LVC in practice due to factors such as lack of knowledge, patient demand, and financial incentives under the reimbursement system. Expert consultations across multiple medical specialties confirmed the relevance of potential LVC procedures and highlighted the need for policies to prevent or reduce their use.
The findings indicated that systematic management of LVC in Thailand is still at an early stage but should remain a priority as addressing this topic has significant potential to reduce waste and enhance patient safety. In conclusion, this study provides an initial foundation for developing a national database and framework for LVC management in Thailand, thereby improving health system efficiency, reducing unnecessary costs, and strengthening the sustainability of healthcare delivery for the population.
