Health policy and planning最新文献

{"title":"Constrained optimization: evaluating possible packages of community health interventions with competing resource requirements in Galmudug, Somalia.","authors":"Robert J Montgomery, Elaine Scudder, Caitlin Tulloch, Muna Jama, Naoko Kozuki, Baris Ata","doi":"10.1093/heapol/czaf014","DOIUrl":"10.1093/heapol/czaf014","url":null,"abstract":"<p><p>Investment in community health worker (CHW) programs has allowed health systems to reach previously underserved rural and remote populations. As a result, CHWs are often burdened with responsibilities to deliver large packages of services, at times without sufficient human, financial, or health resources. To design a community-level program that saves maternal and newborn lives while operating within resource limitations, we used constrained optimization (a mathematical process for finding the solution to a stated objective while accounting for listed requirements) to construct a model for select villages in Galmudug State, Somalia. After establishing the resource requirements for delivering 25 evidence-based maternal and neonatal interventions, we used the Lives Saved Tool and optimization techniques to determine the package of care that leads to the most projected lives saved. With a cadre of 1450 female health workers and a budget of $435 000 for maternal and neonatal health commodities and programming over 1 year, we calculated that the optimized set of interventions for Galmudug could avert 15% of the 4132 projected maternal and neonatal deaths in 2024. We also conducted sensitivity analyses to show how the optimal combination of interventions and the number of lives saved change as the resource levels change. The model provides practitioners with a new tool and accompanying approach to evaluate possible packages of community health interventions with competing resource requirements.</p>","PeriodicalId":12926,"journal":{"name":"Health policy and planning","volume":" ","pages":"566-577"},"PeriodicalIF":2.9,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12063593/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143604622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prioritization of methods for assessing alcohol use in emergency room settings: findings from a qualitative study.","authors":"Petal Petersen Williams, Megan Prinsloo, Jodilee Erasmus, Charles Dh Parry, Richard Matzopoulos, Margaret M Peden","doi":"10.1093/heapol/czaf016","DOIUrl":"10.1093/heapol/czaf016","url":null,"abstract":"<p><p>Limited alcohol-related injury data in hospital settings globally underscore the need for routine monitoring to inform policy formulation for injury prevention, especially in addressing violence and road traffic injuries. COVID-19 and the related alcohol sales bans in South Africa in 2020-21 brought the impact of alcohol on trauma presenting to health facilities into sharp focus and highlighted the absence of practical, cost-effective, and accurate alcohol diagnostic tools in emergency rooms This qualitative study aims to identify valuable alcohol-related information for stakeholders to inform a validation study of alcohol diagnostics for injury-related trauma. We conducted five virtual focus group discussions (FGDs) with four groups of stakeholders: clinicians (n = 9), academics (n = 4), hospital and other operational staff (n = 6), and policymakers (n = 4). FGDs were audio recorded and transcribed verbatim. Coding and thematic analyses were conducted using NVivo version 12. Results highlighted the belief that alcohol places a burden on the healthcare system and plays a significant role in injury causation and mortality. Currently, robust alcohol assessment in emergency rooms is lacking. Despite acknowledging that quantified blood alcohol levels would not change acute clinical management, there was consensus regarding the need-to-know patients' alcohol usage to inform long-term management and broader public health objectives. Findings support plans to validate the efficacy of selected alcohol diagnostic tools in public hospital settings and to further test their feasibility and utility at a national level.</p>","PeriodicalId":12926,"journal":{"name":"Health policy and planning","volume":" ","pages":"548-555"},"PeriodicalIF":2.9,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12063578/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143648398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of the free healthcare policies in Burkina Faso: underscoring important nuances.","authors":"Thomas Druetz, Patrick Ilboudo, Marie-Jeanne Offosse, Federica Fregonese, Abel Bicaba","doi":"10.1093/heapol/czaf017","DOIUrl":"10.1093/heapol/czaf017","url":null,"abstract":"<p><p>The article recently published by Aye et al. (2024) in Health Policy and Planning is a major contribution to understanding the medium-term (5 years) effects of the free healthcare policy introduced in 2016 in Burkina Faso. The study makes rigorous use of interrupted time series with a nonequivalent control group and presents a wealth of information on the methodology used. Remarkably, numerous sensitivity analyses were conducted to strengthen the credibility of the results and limit the risk of bias. Three salient conclusions are presented: (I) free healthcare had no effect on the proportion of pregnant women who gave birth in a health center, either immediately or after 5 years; (II) free healthcare led to an immediate and significant increase in the rate of consultations for children <5 years of age; and (III) after this immediate increase, free healthcare led to a gradual decrease in the rate of consultations for children <5 years in the medium term. We believe it is essential to highlight some important nuances regarding these conclusions and highlight some methodological issues.</p>","PeriodicalId":12926,"journal":{"name":"Health policy and planning","volume":" ","pages":"585-587"},"PeriodicalIF":2.9,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700312","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 and determinants of healthcare-induced poverty in China 2013-2019.","authors":"Linwei Li, Bingqing Guo, Chaojie Liu, Qiang Yao","doi":"10.1093/heapol/czaf026","DOIUrl":"https://doi.org/10.1093/heapol/czaf026","url":null,"abstract":"<p><p>Healthcare costs are a major driver of poverty, accounting for 44.1% of poverty cases in China. By 2015, nearly 20 million people fell into or returned to poverty due to health issues. In response, the Chinese government launched the national health poverty alleviation project in 2016. This study aims to evaluate the distribution and trends of healthcare-induced poverty from 2013 to 2019. Using data from the China Household Finance Survey (CHFS), we estimated the incidence of household catastrophic health expenditures (CHE) and impoverishing health expenditures (IHE) and analyzed their determinants through multi-level logistic regression models. Subgroup analyses were conducted based on rural/urban locations, geographic regions, and provinces. In 2013, 31.83% of households experienced CHE, while 9.56% faced IHE. CHE incidence declined significantly after 2016 (AOR=0.493-0.766, p<0.001). IHE incidence initially increased in 2015 (AOR=1.580, p<0.001) before declining from 2017 onward (AOR=0.465-0.607, p<0.001). The most significant reduction (9.99%-10.95%) occurred among the highest income quartile. CHE and IHE shared similar determinants. Higher odds of CHE and IHE were associated with older age of the household head (AOR=1.225-2.175, p<0.001), rural residency (AOR=1.093-1.199, p<0.05), the presence of an elderly household member (AOR=1.237-1.336, p<0.001), and having more household members in poor self-rated health (AOR=2.455-4.137, p<0.001). Conversely, lower odds of CHE and IHE were associated with higher educational attainment (AOR=0.681-0.879, p<0.001) and employment (AOR=0.610-0.708, p<0.001) of the household head, higher household income per capita (AOR=0.017-0.860, p<0.001), and larger household size (AOR=0.335-0.684, p<0.001). Households in urban areas and the eastern developed region had lower incidences of CHE and IHE compared to others. In conclusion, China has seen a significant decline in CHE and IHE, particularly after implementing the national poverty alleviation project. However, regional, urban-rural, and income-related disparities persist, underscoring the need for equity-focused interventions.</p>","PeriodicalId":12926,"journal":{"name":"Health policy and planning","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144013761","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":"Assessing the role of long-term care insurance in shaping living arrangements of older adults: evidence from China.","authors":"Zhenyu Zhu, Chen Bai","doi":"10.1093/heapol/czaf027","DOIUrl":"https://doi.org/10.1093/heapol/czaf027","url":null,"abstract":"<p><p>The establishment of long-term care insurance (LTCI) has become one of the key measures adopted by countries worldwide to address growing care needs associated with population aging. While existing studies focus on LTCI's impact on medical expenditures and healthcare utilization, its effects on living arrangements of older adults, a core component of long-term care, remain underexplored in China. Living arrangements reflect both well-being of older adults and their approaches to aging. This study examines the effects of China's LTCI pilots on living arrangements of older adults. Using three-wave panel data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS), we analyze the rollout of LTCI pilots across different cities from 2014 to 2021, employing a time-varying difference-in-differences (DID) approach. Our findings indicate that LTCI significantly increases the likelihood of older adults living alone or only with their spouse and decreases their preference for living with adult children. We provide two explanations for the observed effects: LTCI facilitates aging in place through the provision of home and community-based services and enhances older adults' health by reducing the incidence of severe illnesses. The effects of LTCI are shaped by policy design, specifically reimbursement structures. These findings offer valuable insights for developing a universal LTCI system in China and other developing countries.</p>","PeriodicalId":12926,"journal":{"name":"Health policy and planning","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144011758","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":"Community detection and management of mild cognitive impairment in Shanghai: A mixed-methods study.","authors":"Yuan Lu, Dehua Yu, Yvonne Wells, Chaojie Liu","doi":"10.1093/heapol/czaf025","DOIUrl":"https://doi.org/10.1093/heapol/czaf025","url":null,"abstract":"<p><p>Dementia has been regarded as a priority in public health for healthy ageing. Mild cognitive impairment (MCI) detection and management is one of the strategies to confront the challenge of increasing burden of dementia. However, MCI is not well recognised or managed in primary care. This study aimed to assess system barriers relating to MCI detection and management in the community. A mixed-methods study was undertaken over the period from October 2020 to October 2022. First, a focus group study (n=124) in Shanghai explored the experiences of general practitioners (GPs), people with MCI and their informal caregivers, and community health managers using thematic analysis. This was followed by two rounds of national Delphi surveys among 22 eligible experts to solicit their consensus on the system conditions needed for community detection and management of MCI. A questionnaire survey based on the Delphi consultations was conducted with GPs (n=1253) recruited from 56 community health centres in Shanghai to quantify their knowledge, attitudes, and practice (KAP) toward community detection and management of MCI and perceived system barriers. The results were mapped and triangulated in line with the chronic care model and the health system building blocks articulated by the World Health Organization. Potential system barriers were identified from eight themes: (1) Lack of self-management skills and enablement; (2) Lack of family support; (3) Lack of community support; (4) Unprepared healthcare system; (5) Health service delivery deterrence; (6) Inadequate clinical decision support; (7) Lack of case management; and (8) Misaligned clinical information systems. The primary care system in Shanghai is not adequately equipped to handle the task of detecting and managing MCI. Both intrinsic and extrinsic obstacles impede the successful conversion of MCI knowledge into desired actions. A systems approach is needed to confront the challenge of MCI detection and management in China.</p>","PeriodicalId":12926,"journal":{"name":"Health policy and planning","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144003145","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":"Community health worker payment processes: a qualitative assessment of experiences in two Indian states.","authors":"Kheya Melo Furtado, Abha Mehndiratta, Sebastian Bauhoff, Swapna Pawar, Amy Luo, Anushree Jha, Margaret McConnell","doi":"10.1093/heapol/czaf010","DOIUrl":"10.1093/heapol/czaf010","url":null,"abstract":"<p><p>Community health worker (CHWs) remuneration has received some attention in terms of the design of incentives, however, there is a lack of systematic data on the processes by which CHWs are paid. We aimed to study existing payment processes including the role of digitization and its effects on CHW experiences with receiving full and timely compensation, and identify barriers and facilitators to the payment process. We studied payment processes for the Accredited Social Health Activist (ASHA) in India in two states with varying levels of performance and payment systems and conducted 53 in-depth interviews and eight focus group discussions across three categories of respondents (37 ASHA workers, 46 supervisors, and 34 managers/health system leaders). The data was coded thematically using inductive and deductive coding methods organized around five steps of the payment process: (i) recording of work, (ii) claim submission, (iii) claim verification, (iv) claim processing, and (v) payment disbursement. We observed complex sub-processes within each stage of the payment process that adversely impacted payment timelines, CHW workload, and motivation, even where digital tools provide support. Local administrative initiative and positive organizational culture overcame these challenges to standardize and simplify processes for recording work, submitting claims, and maintaining adequate funds, facilitating timely payments. Complete digitization of disbursement through the public financial management system improved timeliness, transparency, and satisfaction among CHWs compared to earlier cash and cheque-based payments. The potential digitization of service delivery records for claim submission was met with mixed perceptions among CHWs and their supervisors. Our study contributes to the body of knowledge on CHW compensation by delineating the processes by which financial incentives are paid and offering insights for low and middle-income countries to improve the efficiency of payment systems.</p>","PeriodicalId":12926,"journal":{"name":"Health policy and planning","volume":" ","pages":"483-495"},"PeriodicalIF":2.9,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11979585/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors influencing the establishment of hospital accreditation programs in low- and middle-income countries: a scoping review.","authors":"Dilantha Dharmagunawardene, Paula Bowman, Mark Avery, David Greenfield, Reece Hinchcliff","doi":"10.1093/heapol/czaf011","DOIUrl":"10.1093/heapol/czaf011","url":null,"abstract":"<p><p>Hospital accreditation programs are globally recognized as an important tool for enhancing quality and safety in health care; however, many programs in low- and middle-income countries (LMICs) are discontinued shortly after their establishment. This scoping review synthesized published evidence on factors influencing the establishment and sustainability of hospital accreditation programs in LMICs, to provide guidance to health stakeholders involved in these processes. Six databases were searched using the terms \"accreditation,\" \"health,\" \"hospital,\" and the country list of LMICs. Screening was undertaken collaboratively for validation. A framework to guide data extraction was developed by amalgamating eight existing classifications, theories, models, and frameworks concerning policy diffusion and implementation. The framework comprised the following domains: antecedent influences (A), contextual factors (C), establishment factors (E), standards, surveyors, stimulants (incentives), and survey-related factors (S-4S), governance (G), legislation (L), execution (implementation; E), and assessment and monitoring (AM), forming the ACES-GLEAM framework. Thirty-two sources were identified, with an increasing publication trend over time. The included studies reported upon a broad range of patterns, innovations, influencers, enablers, and barriers concerning accreditation program establishment in LMICs. Key questions emerged, including the degree of government involvement, incorporation of international standards versus development of bespoke standards, the use of local versus external surveyors, the use of financial and other incentives to promote engagement, and mandatory versus voluntary approaches of program implementation. Resource constraints were recognized as the most important barriers to sustainable establishment, while the influence of global accreditation and donor agencies were viewed as presenting both positive and negative impacts. Health stakeholders are encouraged to reflect upon and apply the ACES-GLEAM framework, incorporating the guiding principles outlined in this paper, to help establish hospital accreditation programs in LMICs in a way that facilitates sustainability and effectiveness over time.</p>","PeriodicalId":12926,"journal":{"name":"Health policy and planning","volume":" ","pages":"496-517"},"PeriodicalIF":2.9,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11979593/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143440749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can public education campaigns equitably counter the use of substandard and falsified medical products in African countries?","authors":"Janelle M Wagnild, Samuel Asiedu Owusu, Simon Mariwah, Victor I Kolo, Ahmed Vandi, Didacus Bambaiha Namanya, Rutendo Kuwana, Babatunde Jayeola, Vigil Prah-Ashun, Moji Christianah Adeyeye, James Komeh, David Nahamya, Kate Hampshire","doi":"10.1093/heapol/czaf004","DOIUrl":"10.1093/heapol/czaf004","url":null,"abstract":"<p><p>Substandard and falsified (SF) medical products are a serious health and economic concern that disproportionately impact low- and middle-income countries and marginalized groups. Public education campaigns are demand-side interventions that may reduce the risk of SF exposure, but the effectiveness of such campaigns, and their likelihood of benefitting everybody, is unclear. Nationwide pilot risk communication campaigns, involving multiple media, were deployed in Ghana, Nigeria, Sierra Leone, and Uganda in 2020-21. Focus group discussions (n = 73 with n = 611 total participants) and key informant interviews (n = 80 individual interviews and n = 4 group interviews with n = 111 total informants) were conducted within each of the four countries to ascertain the reach and effectiveness of the campaign. Small proportions of focus group discussants (8.0-13.9%) and key informants (12.5-31.4%) had previously encountered the campaign materials. Understandability varied: the use of English and select local languages, combined with high rates of illiteracy, meant that some were not able to understand the campaign. The capacity for people to act on the messages was extremely limited: inaccessibility, unavailability, and unaffordability of quality-assured medicines from official sources, as well as illiteracy, constrained what people could realistically do in response to the campaign. Importantly, reach, understandability, and capacity to respond were especially limited among marginalized groups, who are already at the greatest risk of exposure to SF products. These findings suggest that there may be potential for public education campaigns to help combat the issue of SF medicines through prevention, but that the impact of public education is likely to be limited and may even inadvertently widen health inequities. This indicates that public education campaigns are not a single solution; they can only be properly effective if accompanied by health system strengthening and supply-side interventions that aim to increase the effectiveness of regulation.</p>","PeriodicalId":12926,"journal":{"name":"Health policy and planning","volume":" ","pages":"447-458"},"PeriodicalIF":2.9,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11979590/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143004483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Institutionalizing linkages between informal healthcare providers and the formal health system in Nigeria: what are the facilitating and constraining contextual influences?","authors":"Obinna Onwujekwe, Chinyere Ojiugo Mbachu, Irene Agyepong, Helen Elsey","doi":"10.1093/heapol/czaf009","DOIUrl":"10.1093/heapol/czaf009","url":null,"abstract":"<p><p>With most households in rapidly urbanizing cities in low- and medium-income countries using private and informal providers for basic healthcare, the need to establish linkages with the formal sector is paramount in the drive for universal health coverage. Successful and effective linkage of informal healthcare providers to the formal health system requires an understanding of prevailing contextual factors and how they can be modulated to support the linkages. Context plays a pivotal role in shaping the nature and success of any integration efforts. This paper, based on a qualitative study, explored the facilitating and constraining contextual influences shaping the linkage of informal healthcare providers into the formal health system in governance, service delivery, and data reporting. The research was conducted in Enugu and Anambra states in southeastern Nigeria. In-depth interviews were held with 12 senior healthcare managers, 16 primary healthcare facility managers, 32 informal providers, and 16 community leaders. Eight sex-disaggregated focus group discussions were held with health service users. Transcripts were coded in NVivo using a pre-defined coding framework comprising facilitators and constraints at the individual, organisational, and environmental levels. Individual factors that influence linkage of informal providers into the formal health system include personal attitudes towards linkage, capacity of informal providers to deliver quality services, nature of existing relationships between formal and informal providers, and trust in the formal health system. Organizational factors include leadership structure, coordination and accountability mechanisms, functional management capacity of the formal health system, and multiple regulatory frameworks. External factors include supportive health policies on integration, sustainable funding for continuous training and supportive supervision, and global agenda/support for integration. This study has provided valuable insights for decision makers and practitioners for harnessing the contextual factors to link informal healthcare providers successfully and effectively to the formal health system in order to improve access to quality health services in urban slums.</p>","PeriodicalId":12926,"journal":{"name":"Health policy and planning","volume":" ","pages":"471-482"},"PeriodicalIF":2.9,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11979586/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143364586","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}