Health Services Insights最新文献

{"title":"Examining the Cost-Effectiveness of Introducing Patient Navigation Services for Colorectal Cancer Screening Among a Low-Income and Uninsured Population.","authors":"Wen Hsin Chen, Robert Ohsfeldt, Murray Côté, Eva Shipp, Marivel Sanchez, Arica Brandford, Jane N Bolin","doi":"10.1177/11786329251399778","DOIUrl":"10.1177/11786329251399778","url":null,"abstract":"<p><strong>Background: </strong>The colorectal cancer (CRC) screening adherence rate among the uninsured population in the United States (US) is lower than the overall rate across all US adults aged 45 to 75.</p><p><strong>Objectives: </strong>To assess the cost-effectiveness of community health worker (CHW) navigation services promoting CRC screening in a low-income, uninsured population.</p><p><strong>Methods: </strong>Using internal cost and effectiveness data from the Texas A&M Cancer Screening, Training, Education, and Prevention (CSTEP) program, which included 3196 participants, along with published sources such as the U.S. Preventive Services Task Force (USPSTF) recommendations, we estimated incremental cost-effectiveness ratios (ICERs) for CRC screening with CHW navigation versus usual care. The analysis was conducted from a societal perspective using Excel-based modeling in hypothetical cohorts initiating screening at age 45.</p><p><strong>Results: </strong>Under base-case assumptions, a 10 percentage-point improvement in CRC screening attributable to the program increased LYG by 0.160 at an additional lifetime cost of $101, resulting in an ICER of $3098 per LYG. One-way and two-way sensitivity analyses were conducted, varying program costs, screening rate improvements, lifetime CRC costs, and life-years gained (LYG).</p><p><strong>Conclusion: </strong>Our findings underscore the importance of CHW navigation services incorporating CRC screening promotion strategies tailored to uninsured populations to alleviate disparities in colorectal cancer screening and outcomes. Further research should consider the characteristics of uninsured populations, and the applicability of the program targeted for various types of underserved populations.</p>","PeriodicalId":12876,"journal":{"name":"Health Services Insights","volume":"18 ","pages":"11786329251399778"},"PeriodicalIF":2.5,"publicationDate":"2025-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12708994/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145781047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Qualitative Assessment of Low Vision Care Among Optometric Practitioners in Sub-Saharan Africa Using a Health Systems Framework.","authors":"Carl Halladay Abraham, Diane van Staden, Nishanee Rampersad","doi":"10.1177/11786329251399779","DOIUrl":"10.1177/11786329251399779","url":null,"abstract":"<p><strong>Background: </strong>Low vision care and rehabilitation (LVCR) remains critically underdeveloped in sub-Saharan Africa, despite a high prevalence of moderate to severe visual impairment.</p><p><strong>Objective: </strong>This study assessed the current state of LVCR in five sub-Saharan African countries using a modified World Health Organization (WHO) health systems framework.</p><p><strong>Method: </strong>A qualitative design was employed, involving semi-structured interviews which were based on a modified WHO health system building blocks: governance and leadership, health service delivery, human resource, low vision aid and technology, and financing. Optometrists providing low vision care in Ghana, Nigeria, Malawi, Kenya, and South Africa were recruited as participants through a combination of stratified random sampling and snowballing. Thematic analysis was conducted to identify the underlying themes.</p><p><strong>Results: </strong>Practitioners reported systemic deficiencies across all five blocks investigated. Governance and leadership lacked clear policies, coordination, and data infrastructure. Health service delivery was characterized by poor coverage, the absence of dedicated LVCR centres, and limited integration into public health systems. Human resources were inadequate, with no structured training or recruitment of practitioners, and low recognition of the sub-specialty. Essential assistive technologies were largely inaccessible due to high costs and procurement challenges. Financing was insufficient, with patients primarily paying out-of-pocket and health insurance schemes offering limited support.</p><p><strong>Conclusion: </strong>None of the five blocks of the WHO health systems framework were adequate for LVCR in this study. Consequently, strengthening each block particularly governance, workforce development, and financing is essential for advancing equitable and sustainable LVCR systems in sub-Saharan Africa.</p>","PeriodicalId":12876,"journal":{"name":"Health Services Insights","volume":"18 ","pages":"11786329251399779"},"PeriodicalIF":2.5,"publicationDate":"2025-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12681628/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145707950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Opportunities and Challenges of an Integrative Care Structure for Oncological Patients: A Qualitative Analysis of Provider Perspectives.","authors":"Luis Scheck, Jasmin Bossert, Michel Wensing, Nadja Klafke, Regina Poß-Doering","doi":"10.1177/11786329251392422","DOIUrl":"10.1177/11786329251392422","url":null,"abstract":"<p><strong>Introduction: </strong>Considering the global increase in cancer, integrative medicine combines conventional and complementary methods, offering a holistic approach to treating cancer patients. To optimize care and support care continuity for oncological patients, the integrative healthcare structure CCC-Integrativ provided evidence-based, interprofessional counseling in four oncology centers in Southern Germany. A process evaluation explored the program's perceived effects and factors relevant to the implementation process to identify opportunities and challenges for a sustainable implementation of the program.</p><p><strong>Methods: </strong>In a qualitative study, semi-structured guide-based interviews with medical and nursing staff directly and indirectly involved in the program were conducted to explore their perspectives. The generated data were analyzed in a content analysis. Participant perceptions regarding potential program effects and factors influencing its' implementation were first identified through open inductive coding. The Consolidated Framework for Implementation Research (CFIR) was then used as a categorizing analytical framework to guide further coding and facilitate a deeper understanding of the implementation process.</p><p><strong>Results: </strong>N = 21 interviews were analyzed (n = 12 directly involved in counseling; n = 9 indirectly involved through leadership position). Participants perceived an added value of the integrative care approach and expressed a positive attitude towards a continuation of the program. Patient interest in complementary medicine and care, their positive response to the program, and a perceived supportive effect of the interprofessional collaboration were reported as promoting factors. Still, insufficient evidence and a perceived low acceptance of some complementary medicine methods by hospital staff, skepticism, lack of space, and recruitment problems, were identified as key challenges for successful long-term implementation.</p><p><strong>Conclusions: </strong>A variety of factors need to be addressed for sustained implementation. Promoting acceptance of supportive complementary methods is essential for evidence-based, patient-centered cancer care. Consideration of interprofessional care could be a key factor for the long-term implementation of consultations on complementary and integrative healthcare.</p>","PeriodicalId":12876,"journal":{"name":"Health Services Insights","volume":"18 ","pages":"11786329251392422"},"PeriodicalIF":2.5,"publicationDate":"2025-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12665825/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145661050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interprofessional Competencies for Effective Interprofessional Collaborative Practices Amongst Intensive Care Unit Teams in the North West Province, South Africa: A Cross-Sectional Survey.","authors":"Nombulelo Esme Zenani, Suegnét Scholtz, Yolande Heymans, Christmal Christmals","doi":"10.1177/11786329251391944","DOIUrl":"10.1177/11786329251391944","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Intensive Care Unit (ICU) teams depend on practical interprofessional collaborative competencies to deliver comprehensive care, ensuring quality outcomes for critically ill patients. The interprofessional competency domain framework is a key strategy to support and develop attitudes, skills, values, and knowledge needed for effective interprofessional collaborative practices. This study aimed to identify the interprofessional competencies required of ICU teams in North West Province, South Africa, for effective interprofessional collaboration practices in the intensive care unit.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Method: &lt;/strong&gt;A cross-sectional study was conducted among nurses, doctors, clinical facilitators, and pharmacists working in the North West Province ICUs using a structured online self-administered questionnaire. A stratified sampling was used to recruit participants for this study. Descriptive and inferential statistics approaches were used to analyse data. Eighty-eight surveys were completed correctly and retrieved, presenting a 52% response rate of the 168 total population.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The findings suggest that years of experience, age, gender, and professional roles significantly impact how ICU teams perceive and execute interprofessional competencies. The study has shown that ICU teams strongly agree on the importance of all the interprofessional competencies for effective interprofessional collaborative practices in ICU settings. The interprofessional competencies promote patient-centred care, ethical conduct, team engagement, and positive team dynamics amongst the ICU teams. However, there is a need to improve at building interdependent relationships among the ICU teams. Developing interdependent relationships amongst the ICU teams will build on integrated work, communication, appreciation of each professional role, and a positive psychological environment to demonstrate interprofessional competencies. These insights underline the importance of tailored training programmes, such as interprofessional continuous professional development programmes that consider these demographic and team relations factors to enhance interprofessional collaboration practices and patient care in ICU settings.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;This study serves as a first step in determining the importance of interprofessional competencies amongst ICU teams in North West Province, South Africa, and highlights the gaps in the execution of interprofessional competencies in ICU teams. The study further provided recommendations on strategies that can be adopted to enhance the interprofessional competencies of the ICU teams. The study could set a platform for other studies that investigate interventions that could be adopted by healthcare regulatory councils, curriculum developers, and healthcare educators in developing interprofessional continuous professional development programmes for ICU teams. Interprofessional conti","PeriodicalId":12876,"journal":{"name":"Health Services Insights","volume":"18 ","pages":"11786329251391944"},"PeriodicalIF":2.5,"publicationDate":"2025-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12665034/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145654261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementers Perspectives on the Routine Use of Artificial Intelligence in Health Services: A Qualitative Study Using the Consolidated Framework for Implementation Research (CFIR).","authors":"Anna Janssen, Kavisha Shah, Helena Teede, Tim Shaw","doi":"10.1177/11786329251392423","DOIUrl":"10.1177/11786329251392423","url":null,"abstract":"<p><strong>Background: </strong>Interest is growing in the use of Artificial Intelligence (AI) technologies in health care. Health AI innovations have been explored in a range of clinical contexts, yet their implementation into routine practice remains challenging. The aim of this study was to understand the factors that influenced the implementation of AI innovations into routine practice in Australian Healthcare organisations, from the perspective of implementers.</p><p><strong>Methods: </strong>The study used a qualitative methodology. AI implementers were identified via an environmental scan of publicly available information, combined with passive snowballing. In-depth research interviews were undertaken between November 2021 and June 2022. Interviews were audio recorded and transcribed into text for data analysis. Transcripts were inductively coded by the researchers, followed by deductive categorisation of the data using the Consolidated Framework for Implementation Research (CFIR).</p><p><strong>Results: </strong>The study identified 11 different AI innovations being introduced in Australian healthcare organisations, and a total of 12 implementers working on the implementation of these innovations were recruited to participate in the study. Factors influencing the implementation of AI innovations into routine practice were identified across all five domains of the CFIR framework, but the innovation and implementation process domains were emphasised the most in the data. Implementers faced many barriers integrating their innovations into practice including challenges with stakeholder engagement, data access and other technical hurdles, resourcing constrains and lengthy timeframes for implementation.</p><p><strong>Discussion: </strong>The number of Health AI solutions being implemented in routine practice in Australian healthcare organisations is small relative to the uptake of innovation seen in research and industry. This gap is likely a reflection of the length and complexity of the implementation process for Health AI solutions, and barriers that need to be overcome as part of this process.</p>","PeriodicalId":12876,"journal":{"name":"Health Services Insights","volume":"18 ","pages":"11786329251392423"},"PeriodicalIF":2.5,"publicationDate":"2025-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12665011/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145654221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the Delivery and Management of Specialised Post-Diagnostic Care and Support in Young-Onset Dementia: A Cross-Sectional Study.","authors":"Sophie van Westendorp, Cynthia Hofman, Merwin Mortier, Britt Appelhof, Paula Gerring, Raymond Koopmans, Christian Bakker","doi":"10.1177/11786329251388775","DOIUrl":"10.1177/11786329251388775","url":null,"abstract":"<p><strong>Introduction: </strong>The need for tailored services for individuals with young-onset dementia (YOD) is well established. Specialised services exist but regional disparities may hinder timely and appropriate care and support. Yet, a comprehensive overview of such services is currently lacking.</p><p><strong>Objective: </strong>To examine regional disparities in the delivery, access and management of YOD-specialised services in the Netherlands, revealing service gaps and opportunities for future development.</p><p><strong>Design: </strong>An exploratory cross-sectional survey (YOD self-scan) was developed and distributed to 39 Dutch healthcare organisations affiliated with a national YOD knowledge infrastructure, ensuring broad geographical representation.</p><p><strong>Methods: </strong>Quantitative and qualitative data were collected through open- and closed-ended questions between July and August 2023. Descriptive statistics and manifest content analyses were used to assess the delivery and management of YOD-specialised services in terms of utilisation, capacity, accessibility, variety and organisational factors.</p><p><strong>Results: </strong>A total of 1707 individuals with YOD utilised outpatient services, and 801 received permanent residential care. Service delivery and management varied across regions. Rural organisations reported shorter waiting times, more employees who had received specific YOD training, and higher day care utilisation per organisation. Urban organisations offered a broader range of services and more involvement of local governments. Most organisations (72.4%) reported service gaps, including limited day care options, inflexible residential services, and insufficient support for carers, especially children of individuals with YOD. Also, the need for more innovative services and improved coordination was identified.</p><p><strong>Conclusions: </strong>YOD-specialised services are underutilised, likely due to unequal accessibility and regional disparities in the delivery and management of services. Addressing service gaps, expanding capacity, and enhancing knowledge exchange are important for equitable, high-quality care. These findings may inform future research and international efforts to improve equitable access and management of specialised dementia services.</p>","PeriodicalId":12876,"journal":{"name":"Health Services Insights","volume":"18 ","pages":"11786329251388775"},"PeriodicalIF":2.5,"publicationDate":"2025-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12586858/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145458432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Specialised Palliative Care in Day Clinic, Hospital Unit or at Home: Which for Whom and When? A Retrospective Routine Data Analysis.","authors":"Julia Strupp, Stephanie Kunkel, Kevin Liu, Anne Dorr, Johannes Best, Alfred Paul, Almut Föller, Raymond Voltz","doi":"10.1177/11786329251388784","DOIUrl":"10.1177/11786329251388784","url":null,"abstract":"<p><strong>Background: </strong>Palliative care units and specialised palliative home care teams are well established in many countries. Palliative day-care clinics, however, are not. Studies assessing which patients benefit from this setting of care are rare.</p><p><strong>Aim: </strong>This is the first routine data analysis of patients treated in three settings of specialised palliative care within a single geographical region. Our aim was to gain understanding of how patients in this region, where specialised palliative care structures are well-established, differ in their characteristics and treatments, and to explore the potential role of a palliative day-care clinic.</p><p><strong>Design: </strong>Retrospective data were extracted from medical records and analysed using SPSS^® and R^®. Data were analysed using the Shapiro-Wilk, Chi-Square, and Kruskal-Wallis tests. Setting/Participants: Patients (n = 603) were included if they received treatment at either a palliative day-care clinic, a palliative care unit, or a specialised palliative home care service. To cover the \"normal\" pre-pandemic period, the analysis was conducted retrospectively from 31 December 2019.</p><p><strong>Results: </strong>Patients attending the palliative day-care clinic were more likely to have cancer (90%, <i>P</i> < .001), were younger than those receiving specialised palliative home care (66.1, <i>P</i> < .001), had a better ECOG performance status (2, <i>P</i> < .001) and fewer high-complexity symptom domains (3.4, <i>P</i> < .001). Patients in the palliative day-care clinic and the palliative care unit underwent similar numbers of medical procedures and interventions. The majority of patients were admitted to the palliative day-care clinic from home (76%, <i>P</i> < .001) and discharged to the palliative care unit (41.5%, <i>P</i> < .001).</p><p><strong>Conclusions: </strong>The three care models differ in their patient populations, time-based criteria and symptom burden-with the palliative day-care clinic treating younger patients at earlier stages of the disease, with a lower ECOG score and a less complex symptom burden. These variations emphasise the importance of tailoring palliative care to the needs of patients and the progression of their disease. Recognising these differences can enhance integrated care pathways and patient-centred outcomes in various settings.</p>","PeriodicalId":12876,"journal":{"name":"Health Services Insights","volume":"18 ","pages":"11786329251388784"},"PeriodicalIF":2.5,"publicationDate":"2025-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12586867/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145458460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Defining and Measuring the Goldilocks Zone in Healthcare: A Review of Metrics and Models.","authors":"Hannah Yu Kit Lee, Chun En Yau, Kevin Xiang Zhou, Jason Chin Huat Yap, Isaac Kah Siang Ng, Qin Xiang Ng","doi":"10.1177/11786329251388774","DOIUrl":"10.1177/11786329251388774","url":null,"abstract":"<p><p>The \"Goldilocks Zone\", a term borrowed from astrophysics, describes the optimal range where conditions are just right to support life. In healthcare, this metaphor captures the imperative to balance underuse and overuse of medical services, ensuring care is neither excessive nor insufficient but instead maximally effective, equitable, and sustainable. As health systems confront rising costs, workforce constraints, and growing demands for person-centred care, the search for this balance has become increasingly urgent. This review explores how the concept of the Goldilocks Zone can be operationalized in modern healthcare systems. We examine two core dimensions that define this balance: person-centredness and operational efficiency. Person-centredness requires attention to accessibility, patient satisfaction, and equity. Drawing on global data, we explore how barriers such as cost, geography, and social inequality limit access to care, and we highlight the role of robust primary care systems and tailored wait-time benchmarks in ensuring responsive, equitable delivery. At the same time, we caution against the misuse of performance metrics that may obscure real disparities. Operational efficiency is evaluated across the continuum of screening, diagnosis, and care management. We review frameworks such as Wilson and Jungner's screening principles and their modern adaptations, as well as diagnostic threshold models and strategies to reduce inappropriate care utilization. Key indicators, including avoidable hospitalizations and ambulatory care-sensitive condition rates, offer insight into system inefficiencies and opportunities for reform. We propose a practical framework for identifying whether a healthcare system is within the Goldilocks Zone and recommend policy levers to help maintain or widen this zone. Ultimately, the Goldilocks Zone is not a fixed destination but a dynamic and evolving balance that requires continual adaptation. As healthcare systems grow more complex, the value of this metaphor lies in guiding both conceptual thinking and concrete policy design.</p>","PeriodicalId":12876,"journal":{"name":"Health Services Insights","volume":"18 ","pages":"11786329251388774"},"PeriodicalIF":2.5,"publicationDate":"2025-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12586872/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145458340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Authors Response: Healthcare-Seeking Behaviour for Obstetric Complications in Ethiopia: A Multilevel Mixed-Effects Analysis.","authors":"Alehegn Bishaw Geremew, Claire T Roberts, Shahid Ullah, Jacqueline H Stephens","doi":"10.1177/11786329251388771","DOIUrl":"10.1177/11786329251388771","url":null,"abstract":"","PeriodicalId":12876,"journal":{"name":"Health Services Insights","volume":"18 ","pages":"11786329251388771"},"PeriodicalIF":2.5,"publicationDate":"2025-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12579121/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145430966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The 2023 Geographic Distribution of Obstetricians and Gynecologists in Saudi Arabia: Implications for Maternal and Neonatal Health Outcomes.","authors":"Eman Talat M Qattan, Waleed Kattan","doi":"10.1177/11786329251385018","DOIUrl":"10.1177/11786329251385018","url":null,"abstract":"<p><strong>Background: </strong>Maternal and neonatal health outcomes are heavily influenced by equitable access to specialized healthcare providers. Globally, unequal distribution of obstetricians and gynecologists (OB/GYN) has been linked to higher maternal mortality rates and worse neonatal outcomes. In Saudi Arabia, ongoing regional disparities in healthcare infrastructure and workforce distribution continue to affect maternal and neonatal health despite reforms.</p><p><strong>Objective: </strong>This study aims to evaluate the regional distribution of obstetricians and gynecologists (OB/GYN) across Saudi Arabia and its impact on maternal and neonatal health outcomes.</p><p><strong>Methods: </strong>We conducted a cross-sectional secondary data analysis using the <i>2022 Saudi Ministry of Health Statistical Yearbook</i>, covering all 20 health regions. We calculated the number of OB/GYN specialists per 100 000 females by region. Pearson's correlation examined associations between specialist density, population size, infrastructure, and health outcomes. Multiple regression identified predictors of specialist distribution.</p><p><strong>Results: </strong>Specialist distribution varied widely. Rural regions, such as Qurayyat, had the highest specialist-to-female ratio (92 per 100 000), while urban regions, like Riyadh, had the lowest (53 per 100 000). A strong negative correlation existed between population size and specialist density (<i>r</i> = -.748, <i>P</i> < .001). OB/GYN bed availability was the strongest predictor of specialist distribution (β = .908, <i>P</i> < .001).</p><p><strong>Conclusions: </strong>This nationwide analysis highlights significant disparities in the distribution of OB/GYN specialists across Saudi Arabia. Urban regions are underserved relative to their population size, while rural regions often lack adequate infrastructure to support existing specialists. Addressing these imbalances through equitable workforce planning and infrastructure investment is crucial for enhancing maternal and neonatal outcomes in alignment with Vision 2030 goals.</p>","PeriodicalId":12876,"journal":{"name":"Health Services Insights","volume":"18 ","pages":"11786329251385018"},"PeriodicalIF":2.5,"publicationDate":"2025-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12579119/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145431097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}