European Journal of Public Health最新文献

{"title":"Hospital admissions for undocumented immigrants: a comparative analysis of French healthcare coverage schemes.","authors":"Kevin Zarca, Zakaria Bekkar, Thomas Rapp, Isabelle Durand-Zaleski, Anne-Laure Feral-Pierssens","doi":"10.1093/eurpub/ckaf113","DOIUrl":"https://doi.org/10.1093/eurpub/ckaf113","url":null,"abstract":"<p><p>Disparities in healthcare access persist in European countries for undocumented immigrants and are influenced by political issues. In France, healthcare access for this population is divided between two programs: the State Medical Aid (SMA), which provides broad healthcare coverage, and the Urgent and Vital Care (UVC) program, which is limited to life-threatening conditions for those ineligible for SMA or other assistance. Analyzing hospital admissions and costs related to these programs can provide insights into the implications of restricted healthcare access. This retrospective cohort study used data from the French national hospitalization database between 2013 and 2021. All hospital stays involving undocumented immigrants covered under either the SMA or UVC programs were included. The primary outcome was the average cost per hospital stay for each program. Secondary outcomes included length of stay (LOS) and use of intensive care unit (ICU). Multivariable generalized linear mixed models were employed to adjust for patient and hospitalization characteristics. The study included 197 327 patients under SMA and 40 322 under UVC. Emergency department admissions accounted for 47% of SMA hospitalizations compared to 68% for UVC. The average cost per SMA stay was €3758 (95% CI, €3637-€3883), which was 13% lower than UVC stays (average absolute difference, AAD: €504). UVC patients had a 16% higher probability of ICU admission (AAD: 1.08 days in ICU) and a 19% higher total LOS compared to SMA patients. Undocumented immigrants without comprehensive healthcare coverage under SMA incur higher hospital costs, longer stays, and increased ICU admission rates than those covered by SMA.</p>","PeriodicalId":12059,"journal":{"name":"European Journal of Public Health","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144599842","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Causes of diagnostic and treatment delays in locally advanced breast cancer: a nationwide multicenter survey and electronic health records analysis in Turkiye.","authors":"Guldeniz Karadeniz Cakmak, Ufuk Tali, Hakan Balbaloglu, Ilhan Tasdoven, Enver Ozkurt, Hasan Karanlik, İsmail Zihni, Lutfi Dogan, Mufide Akcay, Semra Gunay, Pelin Basım, G Ozan Kucuk, Ahmet Pergel, Gokturk Maralcan, M Umit Ugurlu, Gunay Gurleyik, Arzu Akan, Ali Uzunkoy, Emine Yıldırım, Hande Koksal, Elifcan Haberal, M Ali Gulcelik, Barıs Morkavuk, Taner Kivilcim, B Imge Ucar, H Belma Kocer, Ozge Gumusay, Cihan Uras, Metin Varlı, Yeliz Ersoy, Beyza Ozcinar, Tolga Kafadar, Bartu Badak, Ahmet Dag, Atakan Sezer, Sibel Ozkan Gurdal, Orhan Agcaoglu, N Zafer Canturk, O Eren Yıldız, Kubilay Dalcı, Ayse Altinok, Aysegul Aktas, Abut Kebudi, Ece Dilege, H Figen Batu, Veli Vural, Gurhan Sakman, Yasemin Bolukbasi, Selman Emiroglu, Neslihan Cabioglu, Oguzhan Deniz, A İlker Filiz, A Cihat Yildirim, Duygu Bayir, Ozgur Olmez, Bekir H Bakkal, Burak Bahadir, Banu Alicioglu, M Cagatay Buyukuysal, Yigit Ozaydın, Hamide Kaya, Nurullah Bakir, Mustafa Comert, Vahit Ozmen","doi":"10.1093/eurpub/ckaf108","DOIUrl":"https://doi.org/10.1093/eurpub/ckaf108","url":null,"abstract":"<p><p>Delays in breast cancer (BC) diagnosis and treatment negatively impact survival outcomes. Understanding patient- and provider-related factors behind these delays is crucial. This study aimed to identify nationwide reasons for delayed diagnosis and treatment of locally advanced BC in Turkiye. A prospective, multicenter hospital-based survey was conducted across 35 institutions between 2023 and 2024. Patient- and provider-related delays were assessed via a structured 61-item face-to-face survey, supplemented by clinical data from electronic health records. Delays exceeding 3 months were clinically categorized as significant. A total of 1322 women participated from seven regions across Turkiye. Factors contributing to diagnostic delays on a national level included economic reasons (5.5%), lack of family support (3.3%), lack of knowledge (12.4%), lack of time due to household work (3.8%), difficulty in finding an appointment (6.7%), pregnancy-related reasons (1.1%), fear of losing the breast (8.9%), fear of death (9.8%), and transportation difficulties (5.1%). Provider-related delays were infrequent. About 89.3% of the patients had the initial doctor appointment and 89.6% had the first specialist consultation within one month. Treatment planning was predominantly based on a multidisciplinary team decision in 88.3% of patients. Regarding treatment initiation, 93.2% started required treatment within 1 month of decision. Patient-related factors are the major causes of diagnostic delay in Turkiye. On the other hand, from the provider's perspective, the presence of multidisciplinary teams, including dedicated breast surgeons, represents a key factor in ensuring the timely implementation of diagnostic procedures and treatment strategies.</p>","PeriodicalId":12059,"journal":{"name":"European Journal of Public Health","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144590744","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in pediatric vaccination coverage in Italy from 2000 to 2023.","authors":"Leonardo Villani, Francesco Andrea Causio, Cosimo Savoia, Roberta Pastorino, Walter Ricciardi, Stefania Boccia, Chiara de Waure","doi":"10.1093/eurpub/ckaf107","DOIUrl":"https://doi.org/10.1093/eurpub/ckaf107","url":null,"abstract":"<p><p>Vaccination represents one of the most effective public health interventions. However, a decrease in pediatric vaccination coverage has been observed in Italy, with an increase in vaccine-preventable infectious diseases. To counter this phenomenon, the Italian government approved a compulsory vaccination law in 2017, increasing the number of mandatory vaccinations from four to 10. This study analyzes the trends of vaccination coverages in Italy from 2000 to 2023, with a focus on the impact of the law. Vaccination coverage data were obtained from the Italian Ministry of Health, sorted by antigen. A linear regression and joinpoint regression analysis was performed for each antigen to identify a significant or non-significant change (increase or decrease) in the trend. Vaccination coverages declined steadily until 2015, but with the introduction of the law 119/2017, there was an increase for all antigens, ranging from 1.05% for tetanus to 5.30% for rubella. During the years of the COVID-19 pandemic, a decline in coverage was observed for all antigens, with values ranging from -0.24% for varicella to -2.39% for rubella. Implementing vaccine mandates seem to be useful for increasing vaccination coverages. Likewise, this study showed the negative impact of the COVID-19 pandemic on primary healthcare services, such as vaccination, contributing to a decline in coverage. Health systems should measure vaccination coverages and monitor changes and variations to be resilient toward external stressors and be proactive in tackling crises.</p>","PeriodicalId":12059,"journal":{"name":"European Journal of Public Health","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144590748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early parental death and being not in education, employment, or training (NEET-status) in Norway: a population-wide study on the moderating role of parental education.","authors":"Lamija Delalic, Jonathan Wörn, Bjørn-Atle Reme","doi":"10.1093/eurpub/ckaf081","DOIUrl":"https://doi.org/10.1093/eurpub/ckaf081","url":null,"abstract":"<p><p>Childhood parental death has been linked to adverse young adult outcomes, potentially influenced by family background. This study quantifies the association between parental death during childhood and NEET-status (not in education, employment, or training) in young adulthood, focusing on the moderating role of parental education. Causes of death were leveraged to explore the extent of confounding in the relationship between parental death and NEET-status. The study utilized Norwegian registry data from birth cohorts 1977-87 (574 229 individuals). We identified individuals with and without the experience of parental death between ages 0-17 and tracked their NEET-status between ages 22-29. Poisson regression models estimated incidence risk ratios for NEET years based on parental death, parental education, their interaction, and control variables. To address confounding, causes of death were categorized as more exogenous (i.e. neoplasms) or more endogenous (e.g. suicide or drug-related deaths). Early parental death and lower parental education were both linked to more years in NEET status. Incidence risk ratios varied by cause of death, ranging from 1.19 for neoplasms [95% confidence interval (CI): 1.13-1.25] to 2.36 for drug-related causes (95% CI: 2.17-2.56). Lower parental education amplified the association between NEET-status and parental death from most causes, but to the smallest extent for neoplasms. The association between parental death and NEET status was stronger among individuals with parents with lower parental education. When the cause of death was unrelated to parental education, the modifying effect of parental education was smaller, suggesting that stronger associations in low-education families may largely reflect confounding factors.</p>","PeriodicalId":12059,"journal":{"name":"European Journal of Public Health","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144590745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The influence of case factors and system factors on the timeliness of testing and contact tracing for COVID-19 in The Netherlands.","authors":"Jizzo R Bosdriesz, Elke M den Boogert, Suzan van Dijken, Nicole H T M Dukers-Muijrers, Hannelore M Götz, Irene E Goverse, Tjalling Leenstra, Mariska W F Petrignani, Stijn F H Raven, Maarten F Schim van der Loeff, Susan van den Hof, Kirsten Wevers, Amy A Matser","doi":"10.1093/eurpub/ckaf109","DOIUrl":"https://doi.org/10.1093/eurpub/ckaf109","url":null,"abstract":"<p><p>Source and contact tracing (SCT) is essential to control the transmission of SARS-CoV-2, and the timeliness of SCT is crucial. As little is known about its real-world effectiveness, we investigated the timeliness of SCT in the Netherlands and its determinants. We used routine COVID-19 SCT data from all individuals who tested positive for SARS-CoV-2 at nine Dutch public health services between 1 June 2020 and 28 February 2021 (N = 384 591). We calculated median time intervals between SCT stages. We used multilevel logistic regression to study associations between case factors and system factors, and total SCT delay (symptom onset to SCT initiation >3 days), patient delay (symptom onset to making test appointment >1 day), and response delay (making test appointment to SCT initiation >2 days). The median total SCT interval time was 3 days (interquartile range 2-5). Older age and being a migrant had higher odds of delay; working in health care or education had lower odds of delay. A higher caseload and a scaled-down SCT had higher odds of delay. For age and country of birth, stronger associations with patient delay, and weaker associations with response delay were found. Although SCT during the COVID-19 pandemic might have had merits in prompting people to isolate or quarantine before the availability of a vaccine, the observed interval times indicate that SCT was not fast enough to have a large effect on interrupting transmission chains. Although promising, the added value of digital SCT tools remains uncertain.</p>","PeriodicalId":12059,"journal":{"name":"European Journal of Public Health","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144590747","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"EURO-DOGE by stealth? Concerning developments in the (de)funding of European health civil society.","authors":"Eleanor Brooks, Holly Jarman, Scott Greer","doi":"10.1093/eurpub/ckaf117","DOIUrl":"https://doi.org/10.1093/eurpub/ckaf117","url":null,"abstract":"","PeriodicalId":12059,"journal":{"name":"European Journal of Public Health","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144590746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Basing healthcare decisions on value: patient-reported outcomes for patients diagnosed with breast cancer in a European cohort.","authors":"Ania Gorostiza, Jon Cacicedo, Itxaso Alayo, Andere Frias, Patricia Cobos Baena, Inés Gallego Camiña, Isabel Álvarez López, Marta Fernández Calleja, Alina Rigabert, Maria Victoria Alonso Martínez, Carolina Varela Rodríguez, Valentina Danesi, Andrea Roncadori, Mario Campone, Ane Fullaondo, Borja García-Lorenzo","doi":"10.1093/eurpub/ckaf064","DOIUrl":"https://doi.org/10.1093/eurpub/ckaf064","url":null,"abstract":"<p><p>Improvements in breast cancer survival rate have been achieved through a variety of multimodal therapeutic approaches, which play a key role in the patients' healthcare pathway and their Patient-Reported Outcomes (PROs) from a Value-Based Healthcare (VBHC) perspective. This paper analyses differences in PROs of patients diagnosed with breast cancer according to their healthcare pathway. A cohort of 690 patients diagnosed with breast cancer between 2018 and 2020 at six European sites was used. PROs were assessed at baseline and 6 months using the International Consortium for Health Outcome Measures standard set. Archetypes defined by patient characteristics and treatment trajectories served as the basis for comparison. Multivariate linear regression models were used to analyse differences in PROs across archetypes. Functional scores generally worsened over 6 months, particularly in physical functioning, whereas emotional functioning improved. Archetypes undergoing mastectomy, with or without reconstruction, showed significant decreases in body image perception and satisfaction with breasts. Pain, fatigue, and peripheral symptoms were prevalent in most archetypes, with those receiving chemotherapy reporting the greatest symptom burden. Patients with in situ carcinoma and patients undergoing conservative surgery plus radiotherapy showed minimal deterioration. The use of PROs in a real-world setting enables the identification of differences across patient archetypes based on their therapeutic pathways. This information provides valuable insights for refining patient-centred care guiding VBHC strategies in oncology, developing of personalized care solutions, and facilitating Shared-Decision Making.</p>","PeriodicalId":12059,"journal":{"name":"European Journal of Public Health","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144564716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Blood-borne virus testing in European emergency departments: current evidence and service considerations.","authors":"Elizabeth Smout, Murad Ruf, Maria Buti, Inês Vaz Pinto, Gaia Nebbia, Laura Hunter, Mark A Aldersley, Catarina Esteves, Diogo Medina, Jordi Llaneras, Sam Douthwaite, Emma E Page","doi":"10.1093/eurpub/ckaf103","DOIUrl":"https://doi.org/10.1093/eurpub/ckaf103","url":null,"abstract":"<p><p>Innovative testing approaches are needed to meet global targets for the blood-borne viruses (BBVs) HIV, hepatitis B virus (HBV) and hepatitis C virus (HCV). We conducted a systematic review of BBV testing in emergency departments (EDs) in Europe to evaluate prevalence, effectiveness of ED testing and linkage to care (LTC). We searched PubMed, Embase and Cochrane Library for articles on ED BBV testing published between January 2012 and July 2022. Studies conducted outside Europe or prior to 2012 were excluded owing to epidemiological and healthcare service variation, together with studies that did not report core parameters. Reference lists from included articles were manually searched. Seventeen original articles met the inclusion criteria. Seven studies reported on HIV testing only. ED prevalence: HIV Ab, 0.0%-1.1%; HBsAg, 0.2%-0.9%; and HCV RNA, 0.2%-3.9%. BBV testing uptake varied by policy and offer methodology: opt-out, provider-initiated: 9.7%-44.2%; electronic health record (EHR) modification: 52.1%-88.9%; and opt-in, provider-initiated: 3.9%-37.7%. LTC rates were 8.1%-100% and varied by BBV, generally highest for HIV and lowest for HCV. There was variable detail in outcome reporting and description of clinical LTC pathways. ED BBV testing in Europe is feasible and identifies high numbers of infections (including, where reported, new diagnoses and disengaged patients), often among marginalized populations who use open-access EDs for healthcare. Factors associated with higher levels of sustained testing uptake included opt-out testing (vs opt-in), EHR (vs provider-initiated) and integration of community services. We propose a toolkit of components necessary for a high-performing ED BBV testing programme.</p>","PeriodicalId":12059,"journal":{"name":"European Journal of Public Health","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144564717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic delay in rare diseases in the Campania region: addressing ageing, gender disparities, and the \"postcode lottery effect\" to reduce the patient odyssey.","authors":"Chiara Cirillo, Rossella Duraccio, Mario Fordellone, Emanuele Monda, Bruno De Rosa, Chiara De Stasio, Anna Francesca Smimmo, Anna Fusco, Salvatore Rega, Martina Caiazza, Francesca Marzullo, Raffaele Scarpa, Gioacchino Scarano, Antonio Postiglione, Pietro Buono, Ugo Trama, Massimo Di Gennaro, Giuseppe Borriello, Maria Galdo, Barbara Morgillo, Paolo Chiodini, Giuseppe Limongelli","doi":"10.1093/eurpub/ckaf088","DOIUrl":"https://doi.org/10.1093/eurpub/ckaf088","url":null,"abstract":"<p><p>Our study assessed the time to diagnosis of rare diseases (RDs) in Campania and whether there are determinants of diagnostic delay (DD). Demographic characteristics, date of first medical contact and diagnosis, disease macro-groups, and area of residence of patients were recorded. DD was calculated as the time elapsed (in years) from the onset of symptoms to the RD diagnosis date. Based on the Rare Disease Research Consortium consensus document, a time to diagnosis more than one year was considered DD. A multilevel logistic regression was performed. Seven thousand nine hundred and nine patients were included in the analysis; 47.4% were male. The mean DD was 3.4 years and 46% of patients experienced DD. Predictors of DD were female gender (OR 0.90, 95% CI 0.80-0.98, P < .005), age at diagnosis (OR 1.36, 95% CI 1.27-1.45, P < .001), and province of residence (residence in Naples vs. others; OR 0.80, 95% CI 0.73-0.88, P < .001). Immunological, connective tissue, digestive, genitourinary system diseases, and congenital malformations showed more DD than other disorders. Nearly half of the patients with RD experienced DD. The main determinants of DD were female sex, older age at diagnosis.</p>","PeriodicalId":12059,"journal":{"name":"European Journal of Public Health","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144564718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A model based on artificial intelligence for the prediction, prevention and patient-centred approach for non-communicable diseases related to metabolic syndrome.","authors":"Alejandro Clarós, Andreea Ciudin, Jordi Muria, Lluis Llull, Jose Àngel Mola, Martí Pons, Javier Castán, Juan Carlos Cruz, Rafael Simó","doi":"10.1093/eurpub/ckaf098","DOIUrl":"https://doi.org/10.1093/eurpub/ckaf098","url":null,"abstract":"<p><p>Metabolic syndrome (MetS) is related to non-communicable diseases (NCDs) such as type 2 diabetes (T2D), metabolic-associated steatotic liver disease (MASLD), atherogenic dyslipidaemia (ATD), and chronic kidney disease (CKD). The absence of reliable tools for early diagnosis and risk stratification leads to delayed detection, preventable hospitalizations, and increased healthcare costs. This study evaluates the impact of Transformer-based artificial intelligence (AI) model in predicting and managing MetS-related NCDs compared to classical machine learning models. Electronical medical data registered in the MIMIC-IV v2.2database from 183 958 patients with at least two recorded medical visits were analysed. A two-stage AI approach was implemented: (1) pretraining on 60% of the dataset to capture disease progression patterns, and (2) fine-tuning on the remaining 40% for disease-specific predictions. Transformer-based models was compared with traditional machine learning approaches (Random Forest and Linear Support Vector Classifier [SVC]), evaluating predictive performance through AUC and F1-score. The Transformer-based model significantly outperformed classical models, achieving higher AUC values across all diseases. It also identified a substantial number of undiagnosed cases compared to documented diagnoses fold increase for CKD 2.58, T2D 0.78, dyslipidaemia 1.89, hypertension 3.33, MASLD 5.78, and obesity 4.07. Diagnosis delays ranged from 90 to 500 days, with 35% of missed intervention opportunities occurring within the first five appointments. These delays correlated with an 84% increase in hospitalizations and a 69% rise in medical procedures. This study demonstrates that Transformer-based AI models offer superior predictive accuracy over traditional methods by capturing complex temporal disease patterns. Their integration into clinical workflows and public health strategies could enable scalable, proactive MetS management, reducing undiagnosed cases, optimizing resource allocation, and improving population health outcomes.</p>","PeriodicalId":12059,"journal":{"name":"European Journal of Public Health","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144559548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}