Journal of Health Services Research & Policy最新文献

{"title":"The impact of COVID-19 policy stringency on patient satisfaction with community pharmacies in China: A cross-sectional standardized patient study.","authors":"Ruijian Huang, Dong Roman Xu, Jay Pan, Xiaohui Wang, Yingsong Chen, Qingyuan Xue, Jiamei Liu, Jingyun Xu, Yue Xiao, Feng Jiang, Yanfei Chen, Siyu Ding, Di Wang, Jifang Zhou","doi":"10.1177/13558196251330586","DOIUrl":"https://doi.org/10.1177/13558196251330586","url":null,"abstract":"<p><p>ObjectivesCommunity pharmacies play a crucial role in China's primary health care system. This study aimed to assess the impact of stringent COVID-19 policy responses - such as lockdowns, travel restrictions and operational closures - on unannounced standardized patients' (USPs) satisfaction with community pharmacy services.MethodsA cross-sectional study was conducted from April 2021 to September 2022, using an USPs approach in community pharmacies across China. USPs' satisfaction was measured using validated tools, with closure policies related to COVID-19 as the primary exposure variable.ResultsThe study included 1076 eligible USP visits to community pharmacies. Results indicated that stricter closure policies had a significant negative impact on USPs' satisfaction (β = -0.18, <i>p</i> = 0.019). This negative effect may be attributed to worsened capability of pharmaceutical service providers (β = -0.17, <i>p</i> = 0.002) and accessibility (β = -0.12, <i>p</i> = 0.019). Subgroup analyses demonstrated a negative correlation between stricter closure policies and lower satisfaction levels with regard to accessibility, capability, and communication.ConclusionsCOVID-19 closure policies in China had adverse consequences for the quality of pharmacy services. These findings highlight that governments must act with urgency when addressing abrupt infectious diseases or public health emergencies. Enhancing access to pharmacy services and capability of providers are critical strategies to ensure an effective response to sudden public health crises.</p>","PeriodicalId":15953,"journal":{"name":"Journal of Health Services Research & Policy","volume":" ","pages":"13558196251330586"},"PeriodicalIF":1.9,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143743040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"'Come and work here!' a qualitative exploration of local community-led initiatives to recruit and retain health care staff in remote and rural areas of the UK.","authors":"Andrew Maclaren, Louise Locock, Zoë Skea, Lorraine Angell, Jennifer Cleland, Topher Dawson, Alan Denison, Christina Dobson, Rosemary Hollick, Peter Murchie, Diane Skåtun, Verity Watson","doi":"10.1177/13558196251318607","DOIUrl":"https://doi.org/10.1177/13558196251318607","url":null,"abstract":"<p><strong>Objectives: </strong>The recruitment and retention of health care staff to remote and rural communities is a major challenge. This study explored the experiences of remote and rural communities in trying to attract and retain health care staff and their families in the UK.</p><p><strong>Methods: </strong>Qualitative case studies in five remote and rural communities, two in England and three in Scotland. We conducted interviews with 22 participants across the five sites, including community members actively involved in recruitment and retention, health care professionals, and their family members. Fieldwork combined remote and in-person data collection. We used thematic analysis across cases drawing on asset-based community development as our theoretical framework.</p><p><strong>Results: </strong>Communities undertook various activities such as making promotional videos, social media campaigns, getting involved on interview panels, and informal social integration efforts. They drew on a range of local assets to encourage health care staff to come to the area, including showcasing local landscapes, outdoor activities, a safe, welcoming community for children and families, and good quality of life. They also drew on the skills of local people with backgrounds in marketing, design, communications and photography or film-making. The absence of some key assets posed challenges, particularly lack of housing, schooling provision, employment opportunities for other family members, and cultural activities. Community-led initiatives were often prompted by local dissatisfaction with health organisations' efforts to recruit health care staff, and a wish to exercise some control over recruitment initiatives. Activities were commonly driven by a small number of individuals. While this worked well in some communities, the burden of responsibility could be substantial. This also sometimes led to tension within communities. Retention efforts commonly relied on informal networks of key individuals who intentionally forged social links for incoming families.</p><p><strong>Conclusions: </strong>There is a key role for communities to play in recruitment and retention in remote and rural regions. There is an opportunity to actively engage community members in collaboratively crafting a campaign that highlights the area's key attractions while being mindful of limitations on reliance on an asset-based approach. Retention is a neglected topic, relying on key individuals going out of their way to help newcomers integrate. The formation of a community stakeholder group could help formalise this and reduce reliance on the goodwill and energy of individuals.</p>","PeriodicalId":15953,"journal":{"name":"Journal of Health Services Research & Policy","volume":" ","pages":"13558196251318607"},"PeriodicalIF":1.9,"publicationDate":"2025-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143537237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A qualitative exploration of the perceived barriers and enablers of providing mental health care in rural Australian general practice.","authors":"Belinda Fuss, Tania Shelby-James, Sharon Lawn, Paul Worley, Sam Manger, Caroline Phegan, Megan Rattray","doi":"10.1177/13558196251319654","DOIUrl":"10.1177/13558196251319654","url":null,"abstract":"<p><p><b>Objectives:</b> General practice plays an important role in delivering and supporting mental health care within communities, particularly for those living in rural areas where access to specialised support is limited. This study sought to understand the barriers and facilitators to providing mental health care in rural Australian general practices. <b>Methods:</b> A descriptive qualitative study was undertaken involving online interviews with 14 staff at three rural Australian general practices between June and September 2023. Participants included nurses (<i>n</i> = 4), GPs, (<i>n</i> = 4), reception staff (<i>n</i> = 3) and practice managers (<i>n</i> = 3). Data were analysed using inductive thematic analysis. <b>Results:</b> Our analysis identified three themes: (i) systemic challenges and supportive infrastructure; (ii) health care personnel factors; and (iii) patient characteristics and preferences. Systemic challenges included limited access to services and specialist support, and challenges with information transmission, while the clinic location and set-up were seen as beneficial. Health care personnel factors included interpersonal needs and challenges, time constraints and how to balance care needs, and the difficulties of attracting and retaining a local workforce. Patient characteristics and preferences included societal stigma and individual hesitancy, lack of awareness, understanding and education around mental health and willingness and affordability of travel and using technology. <b>Conclusions:</b> Rural general practice in Australia faces a range of barriers and enablers that shape the provision of mental health care. To address these challenges, collaboration across various sectors will be required. Improving infrastructure, better resource allocation, addressing workforce shortages, reducing stigma, enhancing mental health literacy, and ensuring the accessibility of mental health care services are all crucial steps. It will be important to align policy goals across sectors to improve the delivery of mental health care in rural general practice in Australia.</p>","PeriodicalId":15953,"journal":{"name":"Journal of Health Services Research & Policy","volume":" ","pages":"13558196251319654"},"PeriodicalIF":1.9,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143458175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of digital facilitation to support the use of digital services in general practice in England: An interview study with key stakeholders.","authors":"Bethan Mair Treadgold, Rachel Winder, Helen Atherton, Carol Bryce, John Campbell, Christine Marriott, Jenny Newbould, Stephanie Stockwell, Emma Pitchforth","doi":"10.1177/13558196251316446","DOIUrl":"https://doi.org/10.1177/13558196251316446","url":null,"abstract":"<p><strong>Objective: </strong>Digital services in primary care are becoming more common, yet access to and use of services can create inequities. Our aim was to explore the drivers, priorities, and evolving policy context influencing digital facilitation in primary care as reported by national, regional and local level stakeholders in England.</p><p><strong>Methods: </strong>We conducted online semi-structured qualitative interviews with stakeholders, including those in NHS England organisations, local commissioners for health care, statutory and third sector organisations, those working within the research community, and digital platform providers. Interviews were analysed using a thematic approach.</p><p><strong>Results: </strong>The majority of stakeholders worked in national level roles, in commissioning or statutory and third sector organisations working in relation to digital inclusion and patient access. Demographic inequalities, poor usability of digital primary care services, and low digital skills were perceived to comprise some of the barriers facing patients in accessing and using digital primary care services. Demand pressures in general practice, inconsistent training opportunities in digital services for staff, and conflicting perceptions around who should be responsible in organising digital facilitation were reported as barriers in the organisation and provision of digital facilitation in primary care. Stakeholders shared future visions for digital primary care and recommended focusing on establishing the concept of digital facilitation and promoting the benefits in its adoption.</p><p><strong>Conclusions: </strong>Policy that is specific to digital facilitation and not just to digital services is required to establish clear lines of responsibility, investment in staff time and training, and the development of digital services that work well for various groups of patients and practice staff. A multi-organisational working team involving decision-makers and those working on the ground in general practice is encouraged to establish principles for supporting patients and staff in accessing and using digital primary care services in the NHS in England.</p>","PeriodicalId":15953,"journal":{"name":"Journal of Health Services Research & Policy","volume":" ","pages":"13558196251316446"},"PeriodicalIF":1.9,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143065908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The appropriateness of self-care policy for urinary tract infections among women from racialised minorities and low-income households in the United Kingdom: A qualitative study.","authors":"Agata Pacho, Nicholas Mays, Rebecca E Glover","doi":"10.1177/13558196251313736","DOIUrl":"https://doi.org/10.1177/13558196251313736","url":null,"abstract":"<p><strong>Objectives: </strong>Urinary tract infections (UTIs) can negatively impact quality of life, especially when recurring. Patients often seek medical advice to relieve painful symptoms. UTIs are also the second most common reason antibiotics are prescribed in English primary care. However, overuse and long-term use of antibiotics for suspected UTIs in women can lead to antibiotic-resistant bacteria, making future treatments less effective. The UK's 2019-24 Antimicrobial Resistance National Action Plan aims to raise public awareness about the risks of overusing antibiotics and encourages self-care for minor infections, like uncomplicated UTIs. We explored how feasible and appropriate this approach is.</p><p><strong>Methods: </strong>The transcripts from four online focus groups and 19 one-to-one online interviews involving 25 racialised minority and/or low-income women were analysed thematically. Meetings with lay members of the public with similar socio-demographics and experiences to those we planned on recruiting for the research helped to orientate the study, refine its materials and enhance its recruitment strategies.</p><p><strong>Results: </strong>All participants spoke about UTI-related anxieties, which they experienced differently depending on the frequency and the course of UTI episodes, and how knowledgeable they were about the symptoms. Participants often practised self-care for UTIs before seeking professional advice. They saw consultations with health care professionals as valuable for managing the symptoms of UTIs and navigating self-care options. Those with recurrent UTIs felt they could recognise when they required antibiotics and, therefore, they felt they could take responsibility for minimising overprescribing. Barriers to self-care included high pressure working days and not being able to take time off work to recover.</p><p><strong>Conclusions: </strong>Participants in our study were often able to self-diagnose and assess the severity of their symptoms, which makes them partners in efforts to improve antibiotic stewardship. They still valued consulting professionals for advice and support about their UTIs, irrespective of whether they received a prescription.</p>","PeriodicalId":15953,"journal":{"name":"Journal of Health Services Research & Policy","volume":" ","pages":"13558196251313736"},"PeriodicalIF":1.9,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143006720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tools for the identification of victims of domestic abuse and modern slavery in remote services: A systematic review.","authors":"Bella Tomsett, Johanna Álvarez-Rodríguez, Nigel Sherriff, Natalie Edelman, Anne Gatuguta","doi":"10.1177/13558196241257864","DOIUrl":"10.1177/13558196241257864","url":null,"abstract":"<p><strong>Objective: </strong>To explore the technology-based tools available for supporting the identification of victims of domestic abuse and modern slavery in remote services and consider the benefits and challenges posed by the existing tools.</p><p><strong>Methods: </strong>We searched six academic databases. Studies were considered for inclusion if they were published in English between 2000 and 2023. The QuADS quality appraisal tool was used to assess the methodological quality of included studies. A narrative synthesis was conducted using the convergent integrated approach.</p><p><strong>Results: </strong>Twenty-four studies were included, of which two were professional guidelines; each reported on a distinct technology-based tool for remote services. All tools related to domestic abuse and 21 focused on screening for intimate partner violence among young and mid-life women (18-65) in high-income countries. The review did not identify tools that support the identification of victims of modern slavery. We identified eight common themes of tool strengths, highlighting that the remote approach to screening was practical, acceptable to victims, and, in some circumstances, elicited better outcomes than face-to-face approaches. Five themes pointed to tool challenges, such as concerns around privacy and safety, and the inability of computerised tools to provide empathy and emotional support.</p><p><strong>Conclusions: </strong>Available technology-based tools may support the identification of victims of domestic abuse by health and social care practitioners in remote services. However, it is important to be mindful of the limitations of such tools and the effects individuals' screening preferences can have on outcomes. Future research should focus on developing tools to support the identification of victims of modern slavery, as well as empirically validating tools for screening during remote consultations.</p>","PeriodicalId":15953,"journal":{"name":"Journal of Health Services Research & Policy","volume":" ","pages":"63-76"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11673303/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141288195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving access to inflammatory bowel disease care in Canada: The patient experience.","authors":"Shehzeen Lalani, Holly Mathias, Courtney Heisler, Noelle Rohatinsky, Raza M Mirza, Olga Kits, Sandra Zelinsky, Geoffrey Nguyen, Peter L Lakatos, Sharyle Fowler, Kevin Rioux, Jennifer L Jones","doi":"10.1177/13558196241276979","DOIUrl":"10.1177/13558196241276979","url":null,"abstract":"<p><strong>Objectives: </strong>Canada has one of the highest age-adjusted incidence and prevalence rates of inflammatory bowel disease (IBD). Large patient volumes and limited resources have created challenges concerning the quality of IBD care, but little is known about patients' experiences. This paper aimed to better understand patient-perceived barriers to IBD care.</p><p><strong>Methods: </strong>An exploratory qualitative approach was used for this study. Fourteen focus groups (with 63 total participants) were co-facilitated by a researcher and patient research partner across eight Canadian provinces in 2018. Patients diagnosed with IBD (>18 years of age) and their caregivers were purposefully recruited through Crohn's and Colitis Canada, gastroenterology clinics and communities, and national social media campaigns. Focus group sessions were recorded, transcribed, and analyzed using thematic analysis.</p><p><strong>Results: </strong>Most participants self-identified as being white and women. The analysis generated four key themes regarding patient-perceived barriers and gaps in access to IBD care: (1) gatekeepers and their lack of IBD knowledge, (2) expenses and time, (3) lack of holistic care, and (4) care that is not patient-centered. An additional four themes were generated on the topic of patient-perceived areas of health system improvement for IBD care: (1) direct access to care, (2) good care providers, (3) electronic records and passports, and (4) multidisciplinary care or an 'IBD dream team'.</p><p><strong>Conclusions: </strong>This research contributes to the limited global knowledge on patients' experiences accessing IBD care. It is valuable for the development of care plans and policies to target gaps in care. Patients have identified system-level barriers and ideas for improvement, which should be taken into consideration when implementing system redesign and policy change.</p>","PeriodicalId":15953,"journal":{"name":"Journal of Health Services Research & Policy","volume":" ","pages":"12-20"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142120014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the policy implementation of a holistic approach to cancer investigation in non-specific symptom pathways in England: An ethnographic study.","authors":"Georgia B Black, Ahmad F Khalid, Georgios Lyratzopoulos, Stephen W Duffy, Brian D Nicholson, Naomi J Fulop","doi":"10.1177/13558196241288068","DOIUrl":"10.1177/13558196241288068","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to explore the policy implementation of non-specific symptom pathways within the English National Health Service.</p><p><strong>Methods: </strong>A multi-site ethnographic project was conducted in four hospitals that contained non-specific symptom pathways between November 2021 and February 2023. The research involved observation (44 h), interviews (<i>n</i> = 54), patient shadowing, and document review.</p><p><strong>Results: </strong>The study examined how the policy concept of 'holistic' care was understood and put into practice within four non-specific symptom pathways. Several challenges associated with providing holistic care were identified. One key challenge was the conflict between delivering holistic care and meeting timed targets, such as the Faster Diagnosis Standard, due to limited availability of imaging and diagnostic tools. The interpretation of a holistic approach varied among participants, with some acknowledging that the current model did not recognise holistic care beyond cancer exclusion. The findings also revealed a lack of clarity and differing opinions on the boundaries of holistic care, resulting in wide variation in NSS pathway implementation across health care providers. Additionally, holistic investigation of non-specific symptoms in younger patients were seen to pose difficulties due to younger patients' history of health anxiety or depression, as well as concerns over radiological risk exposure.</p><p><strong>Conclusions: </strong>The study highlights the complexity of implementing non-specific symptom pathways in light of standardised timed cancer targets and local cancer policies. There is a need for appropriately funded organisational models of care that prioritise holistic care in a timely manner over solely meeting cancer targets. Decision-makers should also consider the role of non-specific symptom pathways within the broader context of chronic disease management, with a particular emphasis on expanding diagnostic capacity.</p>","PeriodicalId":15953,"journal":{"name":"Journal of Health Services Research & Policy","volume":" ","pages":"21-30"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11673348/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What can the era of big data and big data analytics mean for health services research?","authors":"David Cromwell","doi":"10.1177/13558196241295970","DOIUrl":"10.1177/13558196241295970","url":null,"abstract":"","PeriodicalId":15953,"journal":{"name":"Journal of Health Services Research & Policy","volume":" ","pages":"1-2"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142558049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Audit of submissions: July 2023-June 2024.","authors":"","doi":"10.1177/13558196241299622","DOIUrl":"https://doi.org/10.1177/13558196241299622","url":null,"abstract":"","PeriodicalId":15953,"journal":{"name":"Journal of Health Services Research & Policy","volume":"30 1","pages":"3"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142895332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}