Medical Gas ResearchPub Date : 2026-03-01Epub Date: 2025-06-28DOI: 10.4103/mgr.MEDGASRES-D-25-00040
Carolina Calderón-Chiu, Montserrat Calderón-Santoyo, Juan Arturo Ragazzo-Sánchez
{"title":"Feasibility of leaf protein hydrolysates to reduce reactive oxygen species and cancer cell proliferation.","authors":"Carolina Calderón-Chiu, Montserrat Calderón-Santoyo, Juan Arturo Ragazzo-Sánchez","doi":"10.4103/mgr.MEDGASRES-D-25-00040","DOIUrl":"https://doi.org/10.4103/mgr.MEDGASRES-D-25-00040","url":null,"abstract":"","PeriodicalId":18559,"journal":{"name":"Medical Gas Research","volume":"16 1","pages":"88-89"},"PeriodicalIF":3.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144528820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Medical Gas ResearchPub Date : 2026-03-01Epub Date: 2025-06-28DOI: 10.4103/mgr.MEDGASRES-D-25-00024
Matthew Chibunna Igwe, Esther Ugo Alum, Alphonsus Ogbonna Ogbuabor
{"title":"Medical gases and long-term oxygen therapy: reducing the chronic obstructive pulmonary disease burden in aging populations in Sub-Saharan Africa.","authors":"Matthew Chibunna Igwe, Esther Ugo Alum, Alphonsus Ogbonna Ogbuabor","doi":"10.4103/mgr.MEDGASRES-D-25-00024","DOIUrl":"https://doi.org/10.4103/mgr.MEDGASRES-D-25-00024","url":null,"abstract":"<p><p>Chronic obstructive pulmonary disease (COPD) is a major global health challenge, disproportionately affecting aging populations in low- and middle-income countries, including Sub-Saharan Africa (SSA). With an increasing prevalence driven by indoor air pollution, tobacco use, and occupational hazards, COPD remains underdiagnosed underdiagnosed and undertreated in the region due to inadequate healthcare infrastructure and resource constraints. This review highlights the critical role of medical gases, particularly long-term oxygen therapy (LTOT), in managing COPD, improving quality of life, and reducing mortality in patients with severe hypoxemia. Although LTOT is well-established in high-income countries, its implementation in SSA faces significant barriers, including limited access, cost, and insufficient awareness. This review analyzes COPD management, LTOT benefits, healthcare policies, and aging demographics in SSA, focusing on experimental studies and synthesizing data for coherence. Relevant articles in English published from 2014 to 2025 were retrieved from PubMed, Scopus, and WHO. Through a comprehensive analysis of the epidemiology of COPD in SSA, the challenges of integrating LTOT, and successful case studies from comparable regions, this review identifies key opportunities for addressing these gaps. Recommendations include strengthening healthcare infrastructure, fostering policy frameworks for LTOT integration, leveraging community engagement, and enhancing patient education. By addressing these challenges holistically and fostering regional and global collaborations, SSA can mitigate the growing burden of COPD and improve health outcomes for its aging populations.</p>","PeriodicalId":18559,"journal":{"name":"Medical Gas Research","volume":"16 1","pages":"46-52"},"PeriodicalIF":3.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144528826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Medical Gas ResearchPub Date : 2026-03-01Epub Date: 2025-06-28DOI: 10.4103/mgr.MEDGASRES-D-25-00023
Costel C Darie, Angiolina Hukovic, Veronica D Maynard, Anca-Narcisa Neagu
{"title":"Roles of oxygen in the tumorigenesis, progression, and treatment of breast cancer.","authors":"Costel C Darie, Angiolina Hukovic, Veronica D Maynard, Anca-Narcisa Neagu","doi":"10.4103/mgr.MEDGASRES-D-25-00023","DOIUrl":"https://doi.org/10.4103/mgr.MEDGASRES-D-25-00023","url":null,"abstract":"<p><p>Breast cancer is the most commonly diagnosed cancer and the second leading cause of cancer death among women worldwide. Poor prognosis in breast cancer patients is often linked to the presence of intratumoral hypoxic areas caused by abnormal vascularization and insufficient oxygen availability, which results in energetic crisis in cancer cells; metabolic and epigenetic reprogramming; the transcription of genes involved in angiogenesis; cancer cell proliferation; increased motility, aggressiveness and metastasis; the accumulation of mutations; genomic instability; the maintenance of stem cell characteristics; stromal cell recruitment; extracellular matrix remodeling; chronic inflammation; immune evasion; and adaptive responses in the tumoral microbiota. Furthermore, hypoxia is often correlated with resistance to traditional antitumor treatments used alone or in combination, which results in the need to implement novel therapies to overcome or alleviate the negative effects of oxygen deprivation in breast cancer theranostics. In breast cancer modeling research, micro- and nanofabrication-based technologies, including breast cancer-on-chip and breast cancer metastasis-on-chip platforms, are able to recapitulate the metastatic cascade of breast cancer in different controlled oxygen gradients. Mass spectrometry-based proteomics, including mass spectrometry imaging, offers opportunities for detecting, quantifying and understanding the roles of proteins and peptides, protein-protein interaction networks, and posttranslational modifications of proteins involved in hypoxia-associated biopathological processes. In this mini-review, we have summarized several modern approaches that are able to overcome the undesirable effects of hypoxia for breast cancer treatment. Thus, natural compounds with inhibitory effects on hypoxia-related signaling pathways in breast cancer cells and the tumor microenvironment, hyperbaric oxygen therapy, viral vector-based therapy that uses genetically engineered oncolytic viruses, and oncological bacteriotherapy based on biohybrid platforms, including anaerobic bacteria that are able to colonize inaccessible hypoxic regions in breast tumors to deliver chemotherapeutic drugs just into the tumor site, and smart nanoplatforms for abundant O2 generation within hypoxic breast cancer areas, including erythrocyte-like nanoparticles, metal-organic framework-nanoparticles, or engineered microalgae-metal-organic framework oxygenators, have been designed to relieve tumor hypoxia, induce antitumor responses, and improve the effects of traditional anti-breast cancer therapies.</p>","PeriodicalId":18559,"journal":{"name":"Medical Gas Research","volume":"16 1","pages":"41-45"},"PeriodicalIF":3.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144528730","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Medical Gas ResearchPub Date : 2026-03-01Epub Date: 2025-06-28DOI: 10.4103/mgr.MEDGASRES-D-24-00162
Ming Sun, Hairui Liang, Yong Chen, Siyu Duan, Rongda Xu, Zhencun Cai
{"title":"A retrospective comparison of hyperbaric oxygen and core decompression for mild to moderate avascular necrosis of the femoral head.","authors":"Ming Sun, Hairui Liang, Yong Chen, Siyu Duan, Rongda Xu, Zhencun Cai","doi":"10.4103/mgr.MEDGASRES-D-24-00162","DOIUrl":"https://doi.org/10.4103/mgr.MEDGASRES-D-24-00162","url":null,"abstract":"<p><p>JOURNAL/mgres/04.03/01612956-202603000-00001/figure1/v/2025-06-28T140100Z/r/image-tiff Avascular necrosis of the femoral head is a condition resulting from disrupted blood supply, leading to ischemia and bone tissue necrosis. Core decompression (CD) restores the blood supply through pressure relief, whereas hyperbaric oxygen (HBO) enhances tissue oxygenation and promotes bone repair. Their combined use may complement each other in improving blood supply, promoting bone healing, and inhibiting disease progression, thus achieving a better therapeutic effect. To assess and compare the efficacy of HBO and/or CD for treating mild to moderate femoral head avascular necrosis, a retrospective study was conducted on patients diagnosed with Ficat stage II non-traumatic osteonecrosis between January 2017 and January 2022 at the Affiliated Central Hospital of Shenyang Medical University, China. A total of 72 patients were divided into HBO, CD, and combination groups, with 24 patients in each group. After 1 year of follow-up, 90% of patients in the HBO group, 85% in the CD group, and 95% in the combination group showed satisfactory improvements in hip joint function. The SF-36 quality of life questionnaire scale scores also significantly improved in all three groups, with the combination group showing the most significant improvement. These findings suggest that HBO offers promising potential for treating non-traumatic femoral head necrosis, with efficacy similar to that of CD. The combination group showed the most significant improvement in both hip joint function and quality of life.</p>","PeriodicalId":18559,"journal":{"name":"Medical Gas Research","volume":"16 1","pages":"1-5"},"PeriodicalIF":3.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144528815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Medical Gas ResearchPub Date : 2026-03-01Epub Date: 2025-06-28DOI: 10.4103/mgr.MEDGASRES-D-24-00129
Mostafa Elshazly, Garuti Giancario, Benan Bayrakci, Jose Luis Sandoval, Hebatallah Hesham Ahmed, Antonio M Esquinas
{"title":"Gas mixture in noninvasive ventilation.","authors":"Mostafa Elshazly, Garuti Giancario, Benan Bayrakci, Jose Luis Sandoval, Hebatallah Hesham Ahmed, Antonio M Esquinas","doi":"10.4103/mgr.MEDGASRES-D-24-00129","DOIUrl":"https://doi.org/10.4103/mgr.MEDGASRES-D-24-00129","url":null,"abstract":"<p><p>Noninvasive ventilation (NIV) and high-flow nasal cannula are increasingly used to treat acute respiratory failure. Because many of these patients could also benefit from inhaled medications, combining aerosol therapy with NIV or high-flow nasal cannula is a promising approach. Effective drug delivery to the lungs is crucial for successful aerosol therapy during NIV. Prior research has identified several factors that affect aerosol delivery efficiency in NIV patients. Medical gases have a long history of use in managing various respiratory conditions. Among them, oxygen is frequently used for patients with hypoxia (e.g., hypoxemic respiratory failure and in newborns). In addition to deoxygenation, helium oxygen mixture and nitric oxide can also be administered through devices such as masks combined with NIV. This narrative review aims to provide a comprehensive overview on the application of gas mixtures (such as helium oxygen mixtures and nitric oxide) in NIV, focusing on their efficacy, safety, and optimization strategies in different clinical settings.</p>","PeriodicalId":18559,"journal":{"name":"Medical Gas Research","volume":"16 1","pages":"59-65"},"PeriodicalIF":3.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144528821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Medical Gas ResearchPub Date : 2026-03-01Epub Date: 2025-06-28DOI: 10.4103/mgr.MEDGASRES-D-25-00029
Alon Gorenshtein
{"title":"Neuroprotection of medical gases: a potential effect on treating cognitive impairments in neurological symptoms of long-COVID.","authors":"Alon Gorenshtein","doi":"10.4103/mgr.MEDGASRES-D-25-00029","DOIUrl":"https://doi.org/10.4103/mgr.MEDGASRES-D-25-00029","url":null,"abstract":"","PeriodicalId":18559,"journal":{"name":"Medical Gas Research","volume":"16 1","pages":"84-85"},"PeriodicalIF":3.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144528828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Medical Gas ResearchPub Date : 2026-03-01Epub Date: 2025-04-19DOI: 10.4103/mgr.MEDGASRES-D-24-00155
Lei Zhang, Jiao Zhu, Zhengjie Miao, Haoli Mao, Hong Jiang
{"title":"Mechanisms by which sevoflurane affects cognitive function in aged marmosets and mice: up-regulation of FKBP5 expression in brain microglia.","authors":"Lei Zhang, Jiao Zhu, Zhengjie Miao, Haoli Mao, Hong Jiang","doi":"10.4103/mgr.MEDGASRES-D-24-00155","DOIUrl":"10.4103/mgr.MEDGASRES-D-24-00155","url":null,"abstract":"<p><p>JOURNAL/mgres/04.03/01612956-202603000-00004/figure1/v/2025-06-28T140100Z/r/image-tiff Inhalation anesthetics may trigger the hypothalamic-pituitary-adrenal axis. FK-506 binding protein (FKBP5) is a critical regulator of the hypothalamic-pituitary-adrenal axis and has been implicated in postoperative cognitive dysfunction. However, how inhalation anesthetics affect the expression and function of FKBP5 in the brain is unclear. We employed single-nucleus RNA sequencing to delineate the hippocampal transcriptomic profiles of the brains of aged marmosets and mice after sevoflurane anesthesia. The results of single-nucleus RNA sequencing revealed that long-term exposure (6 hours) to sevoflurane significantly increased FKBP5 expression in the hippocampus of aged marmosets and mice, especially in microglia. Western blot assay also verified the above results. The Barnes maze test showed that, compared with heterozygous control mice, microglia-specific FKBP5 conditional knockout mice exhibited improved neurocognitive function after sevoflurane/surgery. Transcriptome sequencing analysis was performed on the brains of microglia-specific FKBP5 conditional knockout mice and heterozygous mice after sevoflurane/surgery and further revealed that FKBP5 was related mainly to inflammatory signaling pathways. Therefore, these findings indicate that long-term exposure to sevoflurane increases FKBP5 expression in the hippocampus of aged marmosets and mice, which thereby affects inflammatory signaling pathways and leads to postoperative cognitive dysfunction.</p>","PeriodicalId":18559,"journal":{"name":"Medical Gas Research","volume":" ","pages":"19-25"},"PeriodicalIF":3.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144018678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Medical Gas ResearchPub Date : 2026-03-01Epub Date: 2025-06-28DOI: 10.4103/mgr.MEDGASRES-D-24-00150
Xiao-Tong Ding, Jin-Zhao Huang, Qiu-Song Shen, Rui-Yu Wang, Hou-Ming Kan
{"title":"Effects of pulsed radiofrequency combined with ozone on zoster-associated pain: a systematic review and meta-analysis.","authors":"Xiao-Tong Ding, Jin-Zhao Huang, Qiu-Song Shen, Rui-Yu Wang, Hou-Ming Kan","doi":"10.4103/mgr.MEDGASRES-D-24-00150","DOIUrl":"10.4103/mgr.MEDGASRES-D-24-00150","url":null,"abstract":"<p><p>Pulsed radiofrequency combined with ozone therapy has been a newly proposed treatment method for zoster-associated pain in recent years. To explore the effectiveness of a regimen of pulsed radiofrequency combined with ozone for the treatment of zoster-associated pain. We searched commonly used English databases (the Cochrane Library, PubMed, CINAHL, Embase, and Web of Science) and Chinese databases (the CNKI, WanFang, CBM, and VIP databases) for randomized controlled trials. Two researchers independently screened the literature on the basis of the set conditions and extracted data from the included literature. The meta-analysis was conducted via Review Manager 5.4 software. A meta-analysis was conducted on 18 studies, with a total of 1496 participants (742 in the experimental group and 754 in the control group). The results revealed that the pulsed radiofrequency combined with ozone presented lower unidimensional pain scores (standardized mean difference [SMD] = -1.55, 95% confidence interval [CI] = [-2.04, -1.06]; heterogeneity: P < 0.00001, I2 = 94%; test effect: Z = 6.18, P < 0.00001), a lower pain rating index (mean difference [MD] = -2.65, 95% CI = [-3.86, -1.44]; heterogeneity: P = 0.001, I2 = 85%; test effect: Z = 4.29, P < 0.0001) and presented pain intensity scores (MD = -0.58, 95% CI = [-0.62, -0.54]; heterogeneity: P = 0.61, I2 = 0%; test effect: Z = 27.91, P < 0.00001), a lower Pittsburgh sleep quality index (MD = -1.62, 95% CI = [-2.94, -0.31]; heterogeneity: P < 0.00001, I2 = 93%; test effect: Z = 2.42, P = 0.02), and lower interleukin-6 expression levels (SMD = -1.94, 95% CI = [-2.91, -0.97]; heterogeneity: P < 0.00001, I2 = 93%; test effect: Z = 3.92, P < 0.0001), lower gabapentin consumption (MD = -146.92, 95% CI = [-189.93, -103.91]; heterogeneity: P = 0.23, I2 = 30%; test effect: Z = 6.70, P < 0.00001). Pulsed radiofrequency combined with ozone is an effective treatment for zoster-associated pain that can effectively alleviate patients' pain and improve sleep quality, providing a new treatment option for zoster-associated pain in the future.</p>","PeriodicalId":18559,"journal":{"name":"Medical Gas Research","volume":"16 1","pages":"76-81"},"PeriodicalIF":3.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144528818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Health systems and reformPub Date : 2025-12-31Epub Date: 2025-01-06DOI: 10.1080/23288604.2024.2417788
Boon-How Chew, Pauline Siew Mei Lai, Dhashani A/P Sivaratnam, Nurul Iftida Basri, Geeta Appannah, Barakatun Nisak Mohd Yusof, Subashini C Thambiah, Zubaidah Nor Hanipah, Ping-Foo Wong, Li-Cheng Chang
{"title":"Efficient and Effective Diabetes Care in the Era of Digitalization and Hypercompetitive Research Culture: A Focused Review in the Western Pacific Region with Malaysia as a Case Study.","authors":"Boon-How Chew, Pauline Siew Mei Lai, Dhashani A/P Sivaratnam, Nurul Iftida Basri, Geeta Appannah, Barakatun Nisak Mohd Yusof, Subashini C Thambiah, Zubaidah Nor Hanipah, Ping-Foo Wong, Li-Cheng Chang","doi":"10.1080/23288604.2024.2417788","DOIUrl":"https://doi.org/10.1080/23288604.2024.2417788","url":null,"abstract":"<p><p>There are approximately 220 million (about 12% regional prevalence) adults living with diabetes mellitus (DM) with its related complications, and morbidity knowingly or unconsciously in the Western Pacific Region (WP). The estimated healthcare cost in the WP and Malaysia was 240 billion USD and 1.0 billion USD in 2021 and 2017, respectively, with unmeasurable suffering and loss of health quality and economic productivity. This urgently calls for nothing less than concerted and preventive efforts from all stakeholders to invest in transforming healthcare professionals and reforming the healthcare system that prioritizes primary medical care setting, empowering allied health professionals, improvising health organization for the healthcare providers, improving health facilities and non-medical support for the people with DM. This article alludes to challenges in optimal diabetes care and proposes evidence-based initiatives over a 5-year period in a detailed roadmap to bring about dynamic and efficient healthcare services that are effective in managing people with DM using Malaysia as a case study for reference of other countries with similar backgrounds and issues. This includes a scanning on the landscape of clinical research in DM, dimensions and spectrum of research misconducts, possible common biases along the whole research process, key preventive strategies, implementation and limitations toward high-quality research. Lastly, digital medicine and how artificial intelligence could contribute to diabetes care and open science practices in research are also discussed.</p>","PeriodicalId":73218,"journal":{"name":"Health systems and reform","volume":"11 1","pages":"2417788"},"PeriodicalIF":0.0,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142959818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Health systems and reformPub Date : 2025-12-31Epub Date: 2025-06-09DOI: 10.1080/23288604.2025.2507975
Zixuan Peng, Audrey Laporte, Xiaolin Wei, Jay Pan, Peter C Coyte
{"title":"Do Pro-Competition Healthcare Reforms Always Bring Health Benefits? Evidence from China.","authors":"Zixuan Peng, Audrey Laporte, Xiaolin Wei, Jay Pan, Peter C Coyte","doi":"10.1080/23288604.2025.2507975","DOIUrl":"https://doi.org/10.1080/23288604.2025.2507975","url":null,"abstract":"<p><p>It is already a common practice for many health care systems in the world to opt for mixed markets where different types of health care facilities compete against each other to offer high-quality health care to patients. Nevertheless, little is known about the effects of the interaction between hospitals of the same or different type on patient health outcomes. This study estimated the impacts of aggregate and specific types of hospital competition by hospital-type on the quality of inpatient care using an analysis dataset comprising 267,183 individuals from China. The Herfindahl-Hirschman index was employed to measure the degree of hospital competition, with length of stay, readmission and mortality being used to measure the quality of inpatient care. The Poisson and binomial logistic models combined with the instrumental variable approach were constructed to estimate the impacts of hospital competition. This study generated three key findings: 1) aggregate hospital competition reduced the quality of inpatient care, as evidenced by a rise in the odds of readmission and length of stay; 2) intra-type hospital competition reduced the quality of inpatient care and in general had larger effects on reducing the quality of inpatient care than inter-type hospital competition; and 3) the only exception was in the way that competition between private nonprofit hospitals contributed to better quality of inpatient care. The overarching suggestion is that instead of treating competition as a panacea for improving health, a flexible plan tailored to specific conditions is needed.</p>","PeriodicalId":73218,"journal":{"name":"Health systems and reform","volume":"11 1","pages":"2507975"},"PeriodicalIF":0.0,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144259534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}