Health Services Insights最新文献

{"title":"Tackling Antimicrobial Resistance in the WHO African Region: Progress, Challenges, and Strategic Priorities for the Future.","authors":"Yahaya Ali Ahmed, Walter Fuller, Yidnekachew Degefaw Mazengiya, Laetitia Gahimbare, Joseph Chukwudi Okeibunor, Olushayo Oluseun Olu","doi":"10.1177/11786329261475516","DOIUrl":"10.1177/11786329261475516","url":null,"abstract":"<p><strong>Background: </strong>Antimicrobial Resistance is a critical health challenge in the African Region. This papefactors and review of evidence generated through WHO-supported monitoring and surveillance tools to describe progress in AMR governance architecture and monitoring uptake in addressing antimicrobial resistance in the WHO African region over the past decade, highlight key enabling factors, and propose actions required to address persisting challenges. We reviewed country reports on the implementation of antimicrobial resistance national action plans using the most recent 2024 Tracking Antimicrobial Resistance Country Self-Assessment Survey with multi-sectoral and human health specific indicators, alongside data from the Global AMR/Use Surveillance System databases.</p><p><strong>Main text: </strong>The number of countries with National Action Plans on antimicrobial resistance under the One Health approach increased from 2 (4.3%) in 2015 to 47 (100%) in 2024. Between 2017 and 2024, the number of countries with national guidelines for appropriate antimicrobial use and antimicrobial stewardship programmes increased from 10 (21.3%) to 20 (42.6%). Multisectoral coordination mechanisms rose from 13 (27.7%) in 2015 to 41 (87.2%) in 2024. During the same period, countries conducting nationwide AMR awareness campaigns grew from 2 (4.3%) to 16 (34%), and participation in Global AMR/Use Surveillance System expanded from 7 (14.9%) to 41 (87.2%). Success factors driving this progress include country endorsement and adaptation of global and regional antimicrobial resistance strategies, stronger collaboration among stakeholders including United Nations agencies, civil society, and partners, and use of platforms like Tracking Antimicrobial Resistance Country Self-Assessment Survey and Global AMR/Use Surveillance System to generate data for decision-making.</p><p><strong>Conclusion: </strong>Moving forward, collective efforts from all stakeholders are essential to consolidate progress and contribute to global health security, achieve Universal Health Coverage and Sustainable Development Goals. Additionally, future AMR research agenda should focus on measuring the impact of AMR interventions and developing new AMR prevention and control strategies.</p>","PeriodicalId":12876,"journal":{"name":"Health Services Insights","volume":"19 ","pages":"11786329261475516"},"PeriodicalIF":2.1,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13434887/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148673576","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":"Perceived Impacts of Health Care System Navigation on Health and Well-Being Among Patients With Musculoskeletal Conditions: A Qualitative Study.","authors":"Paige Campbell, Geneviève Jessiman-Perreault, Jean Miller, Romita Choudhury, Kyle McCallum, Jason Martyn, Mel Slomp, Jason Werle, Jill Robert, Breda Eubank, Ania Kania-Richmond","doi":"10.1177/11786329261475438","DOIUrl":"10.1177/11786329261475438","url":null,"abstract":"<p><strong>Background: </strong>Musculoskeletal (MSK) disorders are a leading cause of disability and health care burden globally. While much research has focused on clinical outcomes, treatment efficacy, and system efficiency, less is known about how challenges in navigating the health care system affect patients' physical, psychological, and social well-being. Understanding these lived experiences is crucial to informing system-level care improvements.</p><p><strong>Objective: </strong>To explore patients' experiences navigating the health care system and the associated impacts on their physical, psychological, and social well-being among individuals with musculoskeletal conditions in Alberta, Canada.</p><p><strong>Design: </strong>Qualitative study using the interpretive description approach.</p><p><strong>Methods: </strong>Semi-structured interviews were conducted by telephone with a purposive sample of adult participants who received care for knee (soft tissue), low back (spine), and/or shoulder conditions. Data were analyzed using a framework analytic approach, with particular attention to themes derived from the data related to negative health impacts associated with system navigation.</p><p><strong>Results: </strong>Seventy-three participants completed an interview. The majority of participants described negative health impacts, which they attributed to challenges navigating the MSK health care system. Patient accounts reveal a spectrum of negative health impacts, including physical health deterioration over and above the MSK condition, a range of mental health challenges, and a decline in social well-being. Participants linked these experiences to specific system-level factors such as delays in receiving care, inconsistency in communications and treatment recommendations, care fragmentation, and affordability barriers.</p><p><strong>Conclusions: </strong>These findings underscore the challenges of navigating the health system with an MSK condition, which can hinder recovery, exacerbate suffering, and add additional health burdens. Greater attention to the lived experience of system navigation is needed, alongside integrated, timely, person-centred and holistic approaches to MSK care.</p>","PeriodicalId":12876,"journal":{"name":"Health Services Insights","volume":"19 ","pages":"11786329261475438"},"PeriodicalIF":2.1,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13434879/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148673606","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":"Prevalence and Associated Factors in Nausea and Vomiting Among Pregnant Women in Eastern Ethiopia: A Community-Based Cross-Sectional Study.","authors":"Megertu Obsa Gelmesa, Fitsum Weldegebreal, Mangistu Abera, Aberash Beyene Derribow, Seboka Abebe Sori, Meron Degefa, Abera Kenay Tura","doi":"10.1177/11786329261476125","DOIUrl":"10.1177/11786329261476125","url":null,"abstract":"<p><strong>Background: </strong>Nausea and vomiting in pregnancy (NVP) is a condition characterized by nausea with or without vomiting that occurs during pregnancy. It ranges from mild morning sickness to the most severe form and affects women with significant morbidity and socioeconomic impacts. Despite this, NVP is less frequently studied in community-based populations with low-income settings than expected. Thus, this study aimed to assess the burden of NVP and its associated factors among pregnant women in Eastern Ethiopia.</p><p><strong>Methods: </strong>A community-based cross-sectional study design was conducted from July 1 to 15, 2021, among randomly selected pregnant women from the ongoing Kersa Health and Demographic Surveillance System. A structured, validated, interviewer-administered questionnaire containing the PUQE score was used. Data were entered into Epi-Data 4.6 and exported to SPSS 25 for analysis. Descriptive statistics and bivariable and multivariable logistic regression analysis were performed. Finally, a p-value < 0.05 in the multivariable regression was considered as a cut-off for statistically significant association.</p><p><strong>Results: </strong>Out of 502 recruited women, 495 (98.6%) were included in the study. The prevalence of NVP in pregnancy was 70.3% (95% CI 66.5, 74.3). NVP was more likely among primigravida (AOR: 5.57; 95% CI: 2.57, 12.05), multigravida (AOR: 3.58; 95% CI: 2.08, 6.14), women with a family history of NVP (AOR: 3.23; 95% CI: 1.96, 5.43), and women with no exercise before pregnancy (AOR: 6.20; 95% CI: 3.53, 10.87), whereas women with planned pregnancies were less likely to experience NVP (AOR: 0.50; 95% CI: 0.30, 0.84).</p><p><strong>Conclusions: </strong>The study indicated that 70.3% of pregnant women in eastern Ethiopia experienced NVP. Gravidity, family history of NVP, exercise before pregnancy, and unplanned pregnancy were significantly associated with NVP. Further longitudinal studies are recommended to establish temporal and causal relationships.</p>","PeriodicalId":12876,"journal":{"name":"Health Services Insights","volume":"19 ","pages":"11786329261476125"},"PeriodicalIF":2.1,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13434089/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148673651","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":"Empowering Men's Health: Strategies to Enhance Health-Seeking Behaviour in Rural Limpopo, South Africa.","authors":"Lazarros Chavalala, Lufuno Makhado, Rachel Tsakani Lebese","doi":"10.1177/11786329261472590","DOIUrl":"10.1177/11786329261472590","url":null,"abstract":"<p><strong>Introduction: </strong>Globally, men have reportedly experienced poor health outcomes associated with their poor health-seeking behaviour. Implementing various strategies could help improve men's health-seeking behaviour and achieve better health outcomes among men. This study aimed to develop strategies to improve men's health-seeking behaviour among men in Limpopo Province, South Africa.</p><p><strong>Methods: </strong>A mixed-method multi-phase approach was used. In phase 1, a systematic review was conducted on strategies used to improve men's health-seeking behaviour to evaluate their effectiveness. In phase 2, quantitative and qualitative studies were conducted, and their findings were merged. In phase 3, Strengths, Weaknesses, Opportunities, and Threats (SWOT) analysis was applied to the merged findings to identify factors that are categorised as strengths, weaknesses, opportunities, and threats. The SWOT analysis outcomes were subjected to the Build, Overcome, Explore, and Minimise (BOEM) Model. The BOEM-derived actions were then integrated and used to formulate strategies.</p><p><strong>Results: </strong>A total of 14 strategies were developed and include recognition of the best employees, implementation of patient surveys, intensifying compliance with policies and guidelines, reduction of waiting time, regular staff training, employing male nurses and community health workers, community outreach campaigns, advocacy, introduction of male dedicated sections in existing health facilities, and use of technology.</p><p><strong>Conclusions: </strong>Applying the developed strategies could help improve men's health-seeking behaviour and create awareness of the importance of utilising healthcare services among the male population. It could also address misconceptions and stigma surrounding the use of healthcare services in communities.</p>","PeriodicalId":12876,"journal":{"name":"Health Services Insights","volume":"19 ","pages":"11786329261472590"},"PeriodicalIF":2.1,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13428122/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148653613","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":"Health, Well-Being, Work Ability and Work Conditions Among EAP Non-Users in Canada and the U.S.: A Quantitative Cross-National Comparison Study.","authors":"Hong Ki Chloe Lau, Javier Mencia-Ledo, Kishana Balakrishnar, Sana Siddiqui, Raihana Premji, Paula Allen, Marilyn Grand'Maison, Allison Kelly, Ali Bani-Fatemi, Behdin Nowrouzi-Kia","doi":"10.1177/11786329261471267","DOIUrl":"10.1177/11786329261471267","url":null,"abstract":"<p><strong>Background: </strong>Research on Employee Assistance Program (EAP) effectiveness has expanded in recent years, but comparative research across countries on people who have never used these services remains limited. Also, few studies have examined how low EAP usage relates to broader workplace factors and well-being.</p><p><strong>Objectives: </strong>The present study aims to examine cross-national differences in health, well-being, and work conditions among working adults in Canada and the U.S. who have never used EAPs. Specifically, it explores (1) satisfaction with healthcare, work ability, and job demands; (2) quality of life; (3) self-reported happiness; and (4) key demographic and occupational factors.</p><p><strong>Methods: </strong>This study employed a cross-sectional quantitative design, with adaptation from the international classification of function (ICF) framework. Data were collected through an 87-item online survey, including questions regarding demographic information and validated measures of psychological well-being (OHQ), quality of life (WHOQOL-BREF), and work ability (WAI). Participants included 179 employed adults (Canada: n = 78; U.S.: n = 101) with no prior experience of using EAP services. Data were analyzed using descriptive statistics, standardized between-country comparisons, exploratory subgroup analyses, and linear regression models.</p><p><strong>Results: </strong>No significant national differences were found in overall quality of life or happiness. U.S. participants reported significantly higher overtime hours, while other between-country differences in income, work ability, physical health, and environmental quality of life were generally small or non-significant at the overall country level. Subgroup analyses revealed that socioeconomic factors (e.g., income, education) were stronger predictors of well-being in the U.S. while occupational factors (e.g., work ability, job demands) were more influential in Canada.</p><p><strong>Conclusion: </strong>Cultural, economic, and structural differences between Canada and the U.S. shape how work and well-being interact across populations. Although overall well-being scores were similar between the two countries, differences emerged in predictors of well-being. These findings highlight the need for EAPs to adopt tailored strategies that address the specific needs of vulnerable subgroups within each national context.</p>","PeriodicalId":12876,"journal":{"name":"Health Services Insights","volume":"19 ","pages":"11786329261471267"},"PeriodicalIF":2.1,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13424505/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148653082","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":"Adverse Event Profiles of Monoclonal Antibodies: A Descriptive Analysis of FAERS Data.","authors":"Ghada Alem, Nehad Jaser Ahmed, Maram Ahmed, Mohamed Balaha, Ziyad Almalki, Abdullah Alahmari, Abdulla Alalwan","doi":"10.1177/11786329261473446","DOIUrl":"10.1177/11786329261473446","url":null,"abstract":"<p><strong>Introduction: </strong>Monoclonal antibodies (mAbs) are bioengineered molecules designed to replicate the immune system's precise targeting of pathogens and abnormal cells. While monoclonal antibodies (mAbs) are targeted therapies, they carry risks like immunogenic reactions and drug interactions.</p><p><strong>Objective: </strong>The current study utilizes FAERS to describe the distribution of reported adverse events, patient demographics, and reporting patterns associated with selected monoclonal antibody therapies.</p><p><strong>Methods: </strong>The analysis included all monoclonal antibody adverse event reports in FAERS through March 31, 2025, with subsequent reports and non-monoclonal antibody drugs excluded, and utilized descriptive statistics to present results as numbers and percentages.</p><p><strong>Results: </strong>FAERS data through March 31, 2025, for 18 monoclonal antibodies showed distinct adverse event (AE) patterns. Most AEs occurred in adults aged 18-64, with females reporting more events except for cancer-related mAbs such as cetuximab (67.09% males) and ipilimumab (64.15% males). Healthcare professionals were the primary reporters, though some drugs-like adalimumab (72.13%)-had mainly consumer reports. Common AEs included injection-site pain (7.44%), rash, in addition to reports categorized as \"drug ineffective,\" a MedDRA preferred term used in FAERS to reflect reporter perception of treatment failure (e.g., 17.96% for secukinumab; 28.14% for tocilizumab).</p><p><strong>Conclusion: </strong>The most frequently reported events included treatment-ineffectiveness perceptions and administration issues, which warrant further investigation in controlled studies. Some reports included product use issues such as dose omission or incorrect administration. However, due to the spontaneous reporting nature of FAERS, the relationship between adherence-related issues and clinical outcomes cannot be definitively established. The findings of the study describe reporting patterns in FAERS and may serve as a basis for future pharmacovigilance or epidemiologic research.</p>","PeriodicalId":12876,"journal":{"name":"Health Services Insights","volume":"19 ","pages":"11786329261473446"},"PeriodicalIF":2.1,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13424930/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148653616","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":"Regional Differences in Telemedicine Utilization by Patient in Late and Post-COVID-19 Pandemic Japan.","authors":"Kazuki Ohashi, Kazuhiro Abe, Yoko Shizawa, Zhao Jieyu, Machiko Ukai, Shigekazu Komoto, Katsuhiko Ogasawara","doi":"10.1177/11786329261473469","DOIUrl":"10.1177/11786329261473469","url":null,"abstract":"<p><strong>Background: </strong>The coronavirus disease pandemic spurred a rapid global expansion of telemedicine facilitated by relaxed regulations. While telemedicine can improve access to underserved populations, disparities persist due to demographic, socioeconomic, and geographic factors. In Japan, telemedicine use expanded during the pandemic; however, evidence on post-pandemic utilization remains limited.</p><p><strong>Objective: </strong>To examine telemedicine use during the late- and post-pandemic periods from 2022 to 2024 and identify individual- and municipal-level factors associated with use.</p><p><strong>Methods: </strong>A quantitative retrospective cohort study was conducted in Hokkaido, Japan using administrative claims data. Participants were eligible with at least two outpatient visits between October 2021 and March 2022. These individuals were followed from April 2022 to December 2024 to collect data on the primary outcome: outpatient visit involving telemedicine. Data analysis evaluated associations between the outcome and 34 variables (six individual-level and 28 municipal-level) conceptualized according to Andersen's behavioral model of health service use.</p><p><strong>Results: </strong>Of the 1,482,239 eligible individuals, 0.4% (n=5,965) used telemedicine. The intraclass correlation coefficient indicated that 39% of the variance was attributable to municipal-level factors, rising to 54% among those aged ≥75. Models including population health needs explained most variance (proportional change in variance, 18.5%). Higher telemedicine use was associated with female gender, higher Elixhauser Comorbidity Index, prior opioids or psycholeptic prescriptions, prior telemedicine use, higher proportion of population aged ≥65, financial power index, and more single-parent households. Lower telemedicine use was linked to older age, higher proportion of women aged ≥65, higher proportion engaged in secondary industry, and higher proportion of elderly-only couple households.</p><p><strong>Conclusion: </strong>Telemedicine use in late- and post-pandemic Japan remains low, with marked regional disparities. Population health needs are key determinants, and municipal-level influences are stronger among older adults. Increasing uptake requires infrastructure and policies supporting caregiver involvement and reducing barriers for older and digitally disadvantaged populations.</p>","PeriodicalId":12876,"journal":{"name":"Health Services Insights","volume":"19 ","pages":"11786329261473469"},"PeriodicalIF":2.1,"publicationDate":"2026-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13402776/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148602221","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":"Adapting a Smartphone-Based Auricular Point Acupressure Self-Management Program for Rural Chronic Musculoskeletal Pain: Qualitative Study.","authors":"Jungkyung Min, Peiyin Hung, Jane N Bolin, Rupsikha Bora, Sarah Pace, Patricia Pitones, Hulin Wu, Jennifer Kawi","doi":"10.1177/11786329261472231","DOIUrl":"10.1177/11786329261472231","url":null,"abstract":"<p><strong>Background: </strong>Chronic musculoskeletal pain is more prevalent in rural areas where access to pain interventions, including complementary approaches like Auricular Point Acupressure (APA), remains limited. APA is a non-invasive, needle-free approach, and its smartphone-based self-management delivery model has not been optimized for rural contexts.</p><p><strong>Objectives: </strong>To explore the perspectives of rural partners on adapting a smartphone-based Auricular Point Acupressure-Self-Management (APA-SM) program to better meet rural needs. Study objectives were to: (1) refine the APA-SM program for rural adults, (2) identify implementation barriers, (3) understand practice workflows and engagement, and (4) identify strategies to integrate the APA-SM program into rural pain care.</p><p><strong>Design: </strong>A qualitative study using semistructured focus group interviews.</p><p><strong>Methods: </strong>We conducted six semistructured focus group interviews with 24 participants who were purposively selected across South Carolina and Texas between October and December 2024. Data were analyzed thematically using an inductive approach following Braun and Clarke's methodology. Ethical approval was obtained from a single Institutional Review Board. A limitation of the study was its regionally focused sample, which may hinder generalizability.</p><p><strong>Results: </strong>Four key themes emerged regarding partners' perspectives on the APA-SM program: (1) building trust with rural communities, providing meaningful incentives, and having well-trained research staff; (2) communicating the value of APA and providing support through detailed information, motivational messaging, and guidance on integrating APA into daily routines; (3) ensuring accessibility and usability by providing educational materials in appropriate formats and addressing barriers related to technology gaps and communication needs; and (4) fostering partnerships with rural healthcare systems for effective implementation.</p><p><strong>Conclusion: </strong>These findings provide practical guidance for refining the APA-SM program to better fit the needs, barriers, and care contexts of rural communities.</p>","PeriodicalId":12876,"journal":{"name":"Health Services Insights","volume":"19 ","pages":"11786329261472231"},"PeriodicalIF":2.1,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13400921/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148591299","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":"Medication Safety Risks and Their Management in Finnish Care Units: A Cross-Sectional Survey.","authors":"Anu Saavalainen, Marianne Kuusisto, Carita Linden-Lahti, Emilia Laukkanen, Tero Vahlberg, Anna-Riia Holmström","doi":"10.1177/11786329261472941","DOIUrl":"10.1177/11786329261472941","url":null,"abstract":"<p><strong>Introduction: </strong>Deficiencies in medication safety are a major concern for patient safety. In Finland, health and social care units are mandated to develop unit-based protocols for safe medication management and use (MMU) to address medication safety risks.</p><p><strong>Objectives: </strong>The aim of this study is to examine how unit-based safe MMU protocols are developed in Finnish health and social care settings and how comprehensive the content of these protocols is.</p><p><strong>Design: </strong>A cross-sectional, descriptive study.</p><p><strong>Methods: </strong>An online survey was conducted among Finnish registered nurses and pharmacists working in health and social care settings. Descriptive statistics were used to summarize the data, and statistical tests (t-tests, Mann-Whitney U, Kruskal-Wallis H) were applied to examine group differences. Sum variables were created to assess protocol content comprehensiveness. The study was conducted and reported in accordance with the STROBE guidelines for cross-sectional studies.</p><p><strong>Results: </strong>The survey included 905 participants (90.2% nurses and 9.8% pharmacists). Most respondents (91.5%) reported having a unit-based MMU protocol. Only 11.6% indicated that the protocol was developed through interprofessional collaboration, which was more common in healthcare than in social care. Overall, respondents considered the protocols comprehensive, with no major differences between work environments. The least detailed areas were medication safety management (mean 3.09), medication reconciliation and patient involvement (mean 3.13), and risk management in the MMU process (mean 3.30).</p><p><strong>Conclusions: </strong>Unit-based safe MMU protocols are key tools in describing the MMU process and medication safety practices in Finnish health and social care. However, greater emphasis is needed on interprofessional development, particularly in social care settings, with increased involvement of physicians and pharmacists. Preventive, system-based medication safety risk management needs to be strengthened in the protocols and the competencies of healthcare professionals in the present area.</p>","PeriodicalId":12876,"journal":{"name":"Health Services Insights","volume":"19 ","pages":"11786329261472941"},"PeriodicalIF":2.1,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13396577/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148584163","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":"Deconstructing Pharmaceutical Prices in a Government-Controlled Market: A Hedonic Regression Analysis of B2G Procurement in Thailand.","authors":"Jittakorn Thila, Piriya Pholphirul","doi":"10.1177/11786329261471004","DOIUrl":"10.1177/11786329261471004","url":null,"abstract":"<p><p>Rising pharmaceutical expenditure poses a persistent governance challenge for public health systems in low- and middle-income countries, yet empirical evidence on pricing in Business-to-Government (B2G) settings remains scarce. This scarcity reflects a fundamental constraint where administrative procurement records are rarely accessible for independent analysis. This study addresses that gap by exploiting rare access to 26,652 medication transaction records from Thailand's Comptroller General's Department (CGD) for 2019-2024. Using acute pain medications, a semi-logarithmic hedonic regression decomposes price variation into product-level and institutional-level determinants. Internal product characteristics, including pharmacological class, dosage form, formulation technology, and brand status, account for the majority of price variation. Conventional market mechanisms, such as competitive pressure and procurement volume, generate no meaningful price reduction once product composition is controlled. Institutional governance factors, however, are associated with significant residual effects. Hospitals under non-Ministry of Public Health ministries are associated with price premiums of 13-29% for equivalent products, while Government Pharmaceutical Organization procurement is associated with a 9.6% price reduction. These findings indicate that product characteristics are the dominant drivers of pharmaceutical price variation in B2G markets, while institutional governance factors are associated with residual price differences after controlling for product composition. These residual differences may have relevant implications for procurement practices in fragmented public health systems. Note on causal inference: All reported associations are based on observational cross-sectional data and should not be interpreted as evidence of causal relationships. The regression coefficients reflect conditional correlations between procurement prices and their covariates, controlling for observed product and institutional characteristics.</p>","PeriodicalId":12876,"journal":{"name":"Health Services Insights","volume":"19 ","pages":"11786329261471004"},"PeriodicalIF":2.1,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13379651/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148497580","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}