Journal of Health Services Research & Policy最新文献

{"title":"Addressing the failure of economic measures of value-for-money to reflect societal preferences for health and social care.","authors":"Jonathan A Michaels","doi":"10.1177/13558196261470627","DOIUrl":"https://doi.org/10.1177/13558196261470627","url":null,"abstract":"<p><p>With increasing costs, and an aging population, it is inevitable that demand for health and social care exceeds the available resources. Policymakers seek to maximise value-for-money and, increasingly, use quantitative economic methods to guide such policy. Current characterisation of value is largely based upon health utility and may not align with societal preferences for attributes such as care processes, autonomy and dignity. The limited concept of value provided by quality adjusted life years (QALY), with other factors adding weight to the QALY or inflating thresholds, may distort funding decisions. This essay explores the limitations of current economic methods and argues that these prioritise cost utility calculations and lack appropriate measures for other attributes of health or social care. Many methods require assumptions and simplifications, such as the equivalence of chosen outcomes, leading to unintended or unconsidered consequences. The choice of perspective, handling of unrelated costs, and methodological choices may conceal implicit value judgements, and the values and preferences used may reflect the preferences of specific stakeholders but fail to represent the interests of those likely to bear the opportunity costs of policy decisions. Areas are identified in which there is the potential for improved alignment of decisions with societal values. Existing methods could be used more extensively to identify and quantify societal preferences in terms of monetary value or equivalent health utility. Changes to decision-making processes to favour a net benefit approach over the use of a variable willingness-to-pay threshold, may reduce the current primacy of cost per QALY calculations, and there is a need for a more rigorous approach to the consideration of opportunity costs. It is concluded that without such changes there is a danger that high-cost new technologies will displace more caring aspects of health and social care that are highly valued by society.</p>","PeriodicalId":15953,"journal":{"name":"Journal of Health Services Research & Policy","volume":" ","pages":"13558196261470627"},"PeriodicalIF":2.2,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148549430","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 organisational blind spots in making sepsis and antimicrobial stewardship guidance work: A document review.","authors":"Olivia Lounsbury, Louise Dunsmure, Clare Hird, Jane O'Hara, Graham Martin, Helen Higham","doi":"10.1177/13558196261466860","DOIUrl":"https://doi.org/10.1177/13558196261466860","url":null,"abstract":"<p><p>ObjectivesReducing unnecessary exposure to antimicrobials and minimising preventable deaths from sepsis are in persistent tension in clinical work. Guidance documents are central to shaping clinical and organisational practice, yet there is a gap in understanding how these documents conceptualise the organisational system conditions that influence their use in practice.MethodsUsing content analysis, this qualitative document review analysed 40 national, regional, and local documents from six hospitals systems across England to examine how guidance conceptualises system conditions that influence antimicrobial use in cases of suspected or confirmed sepsis.ResultsWe identified six themes: (1) symbolic use of human factors, (2) an unclear understanding of the end user, (3) an ambiguous fit between national, regional, and local documents, (4) harmony in what is stated, (5) harmony in what is not stated, and (6) a lack of focus on management's role.ConclusionsSystem conditions within organisations will mediate how these documents are enacted in practice. Therefore, future development should consider how documents can guide a coherent fit between clinical, operational, and leadership structures via an effective operating model and the role management plays in achieving this coherence in different settings.</p>","PeriodicalId":15953,"journal":{"name":"Journal of Health Services Research & Policy","volume":" ","pages":"13558196261466860"},"PeriodicalIF":2.2,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148455956","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":"Deficiencies in social and health care during voluntary termination of pregnancy in Spain: women's experiences and perceptions.","authors":"Alba Teresa González-Esteban, Ana Patricia Crespo-Rodríguez, Nazareth Gallego-Morón, Estrella Montes-López, Aidée Baranda Ortiz","doi":"10.1177/13558196261470241","DOIUrl":"https://doi.org/10.1177/13558196261470241","url":null,"abstract":"<p><p>ObjectiveTo explore women's experiences with health and social care during voluntary termination of pregnancy (i.e., abortion) in Spain and to identify areas for improvement in the quality of care provided throughout the process.MethodsA qualitative study was conducted using semi-structured interviews with 30 adult women who underwent a voluntary termination of pregnancy in Spain between 2013 and 2023. Participants were selected to ensure diversity in age, educational level, and geographical region. Interviews were analysed in Atlas.ti using a two-phase deductive-inductive approach, whereby an initial coding framework informed by the literature was refined through the inductive identification of emergent codes and themes from the data.ResultsWomen's experiences were strongly influenced by the quality of care received throughout the abortion process. During the pre-abortion stage, participants reported inadequate information and guidance, insufficient sensitivity and empathy from professionals, non-consensual practices, stigmatizing attitudes, attempts to dissuade them from abortion, and barriers to access from conscientious objection and uneven service provision. During the abortion procedure, women described insufficient information about the intervention, inadequate pain management, denial or improper administration of anaesthesia, and impersonal or unsympathetic treatment during recovery. In the post-abortion stage, deficiencies included inadequate medical follow-up, pressure to adopt contraceptive methods, and limited access to psychological support. Overall, participants' accounts revealed a pattern of shortcomings that negatively affected their emotional well-being and experiences across all stages of the process.ConclusionThe findings highlight systemic deficiencies in health and social care during voluntary termination of pregnancy. Improving abortion care requires person-centred, non-judgemental, and evidence-based services that guarantee adequate information, respectful treatment, timely access, informed decision-making, effective follow-up, and psychological support. Strengthening professional training and implementing mechanisms to monitor and improve quality of care are essential to safeguarding women's sexual and reproductive rights and enhancing their experiences throughout the abortion process.</p>","PeriodicalId":15953,"journal":{"name":"Journal of Health Services Research & Policy","volume":" ","pages":"13558196261470241"},"PeriodicalIF":2.2,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148436523","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":"Have we forgotten our obligation to train health workers on disability? A policy analysis in sub-Saharan Africa.","authors":"Sara Rotenberg, Veronika Reichenberger, Tracey Smythe","doi":"10.1177/13558196261468661","DOIUrl":"https://doi.org/10.1177/13558196261468661","url":null,"abstract":"<p><p>ObjectivesPeople with disabilities have worse health outcomes than people without disabilities, leading to a 10-20-year life expectancy gap. Health workers' attitudes and lack of training are barriers to health care for people with disabilities, yet current training initiatives are unsystematic and limited to specific cadres or institutions. Countries that have adopted the UN Convention on the Rights of Persons with Disabilities likely have legal obligations to train health workers on disability. We sought to explore how this obligation is included in disability laws and policies in sub-Saharan Africa, as this is an important indication of activities to close the health gap for people with disabilities.MethodsWe searched the two available databases on disability laws: WHO MiNDBANK and UN websites for disability laws and policies for each country to systemically extract information across 11 domains.Results57 documents in English, French, and Portuguese from 31 countries were included. No relevant documents were found for 18 countries. Of the most recent document for each country, nearly half (<i>n</i> = 16, 52%) had no mention of disability training, while the remaining countries required or mandated it (<i>n</i> = 15; 49%, respectively). Most laws and policies had limited details, though more robust ones had information on budget allocation, competencies, and cadres included.ConclusionsTherefore, several countries in sub-Saharan Africa include health worker training in disability laws, but more detailed policies could improve disability training initiatives.</p>","PeriodicalId":15953,"journal":{"name":"Journal of Health Services Research & Policy","volume":" ","pages":"13558196261468661"},"PeriodicalIF":2.2,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148421124","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 impact of congenital cytomegalovirus infection among families and caregivers: A qualitative analysis of responses to a public consultation on newborn screening in the UK.","authors":"Rosamund Greiner, Sarah Dewar, Christine E Jones, Marthe Le Prevost, Tushna Vandrevala, Cristina Visintin, Heather Bailey","doi":"10.1177/13558196251382548","DOIUrl":"10.1177/13558196251382548","url":null,"abstract":"<p><p>ObjectivesTo describe the impact associated with congenital cytomegalovirus (cCMV) infection and experiences and perceptions of people with experience of CMV in pregnancy and families / caregivers of children diagnosed with cCMV, who responded to a UK National Screening Committee (UK NSC) public consultation on cCMV screening.MethodsThe public consultation was conducted in 2021-22 on a draft evidence review and was aimed at informing the UK NSC's decision on newborn screening for cCMV. Data were analysed using framework analysis: a subgroup of responses was inductively coded, codes were refined and initial themes identified, before targeted coding of the remainder of the data and identification of final themes and sub-themes.ResultsOf a total 155 responses, 125 (describing 128 pregnancy/child outcomes) contained information relevant to the coding framework and were included. Most (n = 109) described a live birth of a surviving child, of whom 90% (98/109) were living with symptoms or long-term sequelae of cCMV at the time of the response. Two main themes were identified: missed opportunities and emotional impacts attributed by respondents to not screening for cCMV. Many families described delays in their child's cCMV diagnosis, including due to healthcare professionals' lack of awareness of cCMV, and viewed newborn screening as a solution to avoid delays in diagnostic pathways. Diagnostic delays resulted in a lasting sense of injustice and unfairness due to possible missed opportunities to improve outcomes (e.g., through antiviral treatment or early therapies), as well as uncertainty and anxiety.ConclusionsResponses were predominantly from parents and caregivers of children with cCMV who experienced long term disability. They highlight significant gaps in awareness, support and health care for affected children that need addressing, regardless of national screening policy decisions. These responses contribute to the literature on lived experiences of individuals and families affected by cCMV.</p>","PeriodicalId":15953,"journal":{"name":"Journal of Health Services Research & Policy","volume":" ","pages":"151-160"},"PeriodicalIF":2.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13263457/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145251388","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":"Pharmacist personas: A tool to guide learning and career development.","authors":"Imelda McDermott, Jolanta Shields, Natalie Tse, Ellen Schafheutle, Paula Higginson, Matthew Shaw","doi":"10.1177/13558196251405199","DOIUrl":"10.1177/13558196251405199","url":null,"abstract":"<p><p>Healthcare systems worldwide are grappling with workforce crises, prompting policy interventions that expand the clinical roles of healthcare professionals. This essay examines the challenges associated with the increasing responsibilities of pharmacists, particularly within the context of the UK's policy aimed at achieving a unified \"one pharmacy workforce.\" This policy envisions pharmacists playing expanded roles in patient care, including enhanced clinical services with an increasing level of independent prescribing. However, there is currently a fragmented approach to training, support, and career progression, which varies substantially across hospital, primary care, and community pharmacy settings. This essay highlights the significant disparities in professional development opportunities across these settings, which hinder the realisation of a unified pharmacy workforce. To address this, we argue that the development of \"pharmacist personas\" can offer a tool to guide pharmacists' learning and career development in their evolving roles. Drawing on Goffman's dramaturgical theory, pharmacist personas can be seen as existing in the space between the \"frontstage\" (the social mask) and the \"backstage\" (the true self), becoming deeply embedded within pharmacists' professional identity work. Personas offer pharmacists a tool to visualise their future professional roles and elucidate the learning to attain them. By providing concrete examples of professional trajectories, personas can guide learning and career development. A policy focused solely on expanding the role of pharmacists is insufficient. It needs to be supported with systemic improvements in training and support to ensure a sustainable \"one pharmacy workforce\" that meets the evolving needs of healthcare systems.</p>","PeriodicalId":15953,"journal":{"name":"Journal of Health Services Research & Policy","volume":" ","pages":"190-195"},"PeriodicalIF":2.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13263453/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145634298","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":"A scoping review of how the candidacy framework has been used in research on access to general practice.","authors":"Carol Sinnott, Akbar Ansari, Evleen Price, Sarah Ball, Stephanie Stockwell, Jessica Dawney, Jennifer Newbould, William D Phillips, Jake Beech, Hugh Alderwick, Mary Dixon-Woods","doi":"10.1177/13558196251406207","DOIUrl":"10.1177/13558196251406207","url":null,"abstract":"<p><p>ObjectivesAccess to general practice is a pervasive health services concern. A tendency to conceptualise access narrowly in terms of supply of appointments may frustrate identification of better solutions. The Candidacy Framework offers an alternative conceptualisation of access as a dynamic and contingent process. We aimed to identify how the Candidacy Framework, and each of its seven features, has been applied and critiqued in research in general practice.MethodsWe conducted a scoping review involving a search across four databases to identify general practice articles, editorials, books, and theses that applied the Candidacy Framework. Included studies underwent data extraction and findings were analysed descriptively.ResultsOf 12,759 records screened, 73 studies published between 2007 and 2024 were included in the review. The Candidacy Framework was predominantly used in designing research or supporting interpretation of research findings. Sixty-seven papers explicitly used at least one of the seven features of candidacy; 'navigation' was the feature most mentioned and 'operating conditions' least. Candidacy appeared particularly helpful for: (1) exploring healthcare staff-patient interactions; (2) understanding barriers and enablers to accessing care; and (3) exploring complex access challenges faced by disadvantaged groups. Critiques of the framework focused on perceived linearity, lack of acknowledgement of the potential for multiple candidacies, and a need for more emphasis on contextual influences beyond local operating conditions.ConclusionThe Candidacy Framework is a useful approach for understanding access to general practice and may help in generating actionable solutions but may be enhanced by further customisation for the specifics of this setting.</p>","PeriodicalId":15953,"journal":{"name":"Journal of Health Services Research & Policy","volume":" ","pages":"196-209"},"PeriodicalIF":2.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13263460/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145762997","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":"Double-checking in the safe administration of medicines: Policy and practice in English hospitals.","authors":"Daisy Halligan, Hana Shamsan, Francesca Wilson, Robbie Foy, David Phillip Alldred, Rebecca Lawton","doi":"10.1177/13558196261421472","DOIUrl":"10.1177/13558196261421472","url":null,"abstract":"<p><p>ObjectivesDouble-checking medication administrations is one of the most frequently used strategies to prevent errors and associated harm. This practice is time-consuming, introduces repeated interruptions into the care process and lacks evidence of effectiveness. Double-checking is widespread in hospitals worldwide. In England, double-checking happens despite there being no regulatory requirement except for intravenous drugs and medicines that require complex calculations. Many hospital Trusts have assimilated double-checking over the past 25-30 years in response to recommendations from the investigation of medication administration errors. There is currently no national picture in England of the extent to which organisational policies stipulate double-checking, the variation in double-checking policy or how closely double-checking is perceived to be conducted in accordance with policies. This study set out to address these gaps in our understanding.MethodsAn online survey was distributed to a network of Medication Safety Officers (MSOs) and Freedom of Information requests were sent to 118 English NHS acute hospital Trusts for policies underpinning medicines administration. Data were analysed to address the research questions.ResultsPolicies were received from 94 acute NHS Trusts (80% response rate) and 48 MSOs submitted a survey response (39% response rate). Double-checking policies vary considerably between Trusts. MSOs perceived that it is common in practice for double-checking not to be conducted in accordance with policy. All reviewed Trust policies required double-checking for controlled drugs. Further to this, many required double-checking for specific medicines or in particular circumstances. Most commonly, these were intravenous medicines, medicines administered to children, medicines requiring complex calculations and cytotoxic or chemotherapeutic medicines. However, policies varied considerably around administration of injectable medicines and insulin to adults. A minority of policies specified that 'intravenous fluids' needed to be double-checked. Most policies neither emphasised nor explained the importance of the independent nature of double-checking. There was also a great deal of variation between Trust policies in the medicines exempt from double-checking requirements.ConclusionsThe variation between policies identified by the present study might reflect a lack of robust evidence underpinning the practice of double-checking. Research is needed to understand if double-checking is effective at preventing medication errors and, if it is, the exact circumstances in which it is effective, to facilitate the standardisation of double-checking policies. Identifying circumstances in which double-checking is ineffective may justify the removal of some existing policies and could reduce nurse workload to free up time for patient-focused care.</p>","PeriodicalId":15953,"journal":{"name":"Journal of Health Services Research & Policy","volume":" ","pages":"144-150"},"PeriodicalIF":2.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146119187","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":"Staff experiences of implementing patient-initiated follow-up (PIFU) in the NHS in England: findings from a rapid qualitative evaluation.","authors":"Cyril Lobont, Rachel Hutchings, Stuti Bagri, Nadia Crellin, Theo Georghiou, Stephanie Kumpunen, Jenny Negus, Pei Li Ng, Camille Oung, Angus I G Ramsay, Sarah Reed, Chris Sherlaw-Johnson","doi":"10.1177/13558196261421165","DOIUrl":"10.1177/13558196261421165","url":null,"abstract":"<p><p><i>Objectives</i>The NHS in England has introduced various innovations to keep up with the growing demand for elective care, one of which is patient-initiated follow-up (PIFU). This evaluation sought to understand staff experiences of implementing PIFU.<i>Methods</i>We conducted a rapid qualitative service evaluation between June 2022 and July 2023, based on semi-structured interviews (n = 36) with operational/managerial and clinical NHS staff from five English NHS Trusts, and an online workshop with 21 additional members of staff from the English NHS. We drew on the Non-adoption, Abandonment, Scale-up, Spread and Sustainability (NASSS) framework to structure qualitative data collection and analysis and to generate new insights into the adoption of the innovation of PIFU.<i>Results</i>We found that implementation of PIFU affected staff roles, workload, and job satisfaction. Levels of PIFU uptake, and experience with similar models, affected the extent to which participants experienced the impact of PIFU. How PIFU was implemented varied. Some staff saw changes in their role because of new administrative demands, safety-netting procedures (such as proactive measures by specialty teams to mitigate the risk of patients not initiating appointments when necessary), and selection of suitable patients. PIFU was felt by some staff to increase, and by others to decrease, workload. PIFU affected intensity of work, interrelated with other factors such as the size of waiting lists, and conditions experienced by patients. Whether staff were satisfied with PIFU related to its impact on their role and workload. Satisfaction was also affected by whether staff believed PIFU delivered benefits for patients, and by the aims they felt were driving rollout.<i>Conclusion</i>PIFU can significantly affect the experiences of staff and change staff roles and workload. However, the impact of PIFU is not uniform. Staff perspectives on PIFU from all parts of the health system should be better understood and considered during pathway design.</p>","PeriodicalId":15953,"journal":{"name":"Journal of Health Services Research & Policy","volume":" ","pages":"161-172"},"PeriodicalIF":2.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13263458/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146093160","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":"Factors influencing the match between patient needs and primary care services: Patient and healthcare provider perspectives from two Canadian provinces.","authors":"Emilie Dufour, Maria Mathews, Emily Gard Marshall, Mylaine Breton, Jennifer E Isenor, Dana Ryan","doi":"10.1177/13558196251405192","DOIUrl":"10.1177/13558196251405192","url":null,"abstract":"<p><p>ObjectivesThis study aims to combine the perspectives of patients and healthcare providers on the factors that influence the match between patients' needs for and providers' capacity to deliver services.MethodsA qualitative descriptive study design was used to examine perspectives and experiences of patients, family physicians and nurse practitioners in two jurisdictions in Canada: Nova Scotia and Ontario. Data from interviews were analyzed using the concept of comprehensiveness, the extent to which the approach to care and services delivered by providers meets patients' needs, to examine how decisions were made in each province for patients to become members of a providers' panel (the process known as 'empanelment').ResultsInterviews with 33 providers and 25 patients were conducted in Nova Scotia and Ontario. Three areas of tension were identified in patients' decision-making about choosing a regular primary care provider and providers' decision-making about accepting regular patients. Patients and providers discussed the success of such a match as being influenced by personal characteristics, including attitudes, gender and cultural background, scope of practice and panel composition.ConclusionsFindings support the value of team-based care that considers the needs for empanelment of both patients and providers. This study provides healthcare providers with information to improve matching processes by incorporating these considerations (e.g., patient and provider sex, gender and chronic care needs) into decisions about empanelment. Mechanisms that reflect the characteristics and range of skills of the whole team rather than the family physician and nurse practitioner alone are an avenue for optimizing the success of empanelment.</p>","PeriodicalId":15953,"journal":{"name":"Journal of Health Services Research & Policy","volume":" ","pages":"181-189"},"PeriodicalIF":2.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13263452/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145648643","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}