Behavioral economics in the hospital: Reducing low-value care in a field experiment

Thumbnail Image
Issue Date
Journal Title
Journal ISSN
Volume Title
Low-value care is an important problem in medicine, resulting in wasted resources and avoidable side effects. Behavioral interventions among medical practitioners have been used to address this, but the question remains how this can be done most effectively and what role behavioral economics can play. In an intervention on low-value care in catheter use among nurses at the Radboudumc, I tested two behavioral intervention models, the COM-B model and the Theoretical Domains Framework, and sought to find to what extend they are useful in designing, implementing and evaluating a behavioral intervention to reduce inappropriate catheter use. Using these frameworks, I held focus groups to help find the barriers and enablers to a behavioral change, designed and implemented the intervention, and tested its results through both objective outcomes and survey data. The focus groups showed the need for addressing nurses’ attention, routines and motivation. The intervention proved successful in increasing the number of catheters with appropriate indications, and nurses reported behavioral changes where we aimed for them. This shows the effectiveness of using the COM-B model and TDF as theoretical frameworks to behavioral interventions. The approach and models followed in this thesis show promise in achieving the desired behavioral change and might be helpful when addressing low-value care or pursuing other behavioral change.
Faculteit der Managementwetenschappen