International Journal of Health Planning and Management最新文献

{"title":"Public-Private-Partnerships for Primary Care in India, Pakistan and Bangladesh: Lessons on Pathways and Drivers.","authors":"Shehla Zaidi, A Venkat Raman, Mahbub Elahi Chowdhury, Farooq Azam, Priya Balasubramanium","doi":"10.1002/hpm.3947","DOIUrl":"https://doi.org/10.1002/hpm.3947","url":null,"abstract":"<p><p>Formalised public-private-partnerships (PPPs) for primary care have proliferated in the mixed health systems of India, Pakistan and Bangladesh, managed and funded by the state. This perspective provides a process-based understanding of pathways adopted by home-grown PPPs and underlying drivers to identify lessons for advancement under Universal Health Coverage (UHC). PPPs have been deployed to respond to local primary care needs ranging from diagnostic screening, maternity services, management of government health centres, mobile clinics to urban primary care systems. Partnerships have evolved to include a diverse range of private partners and more purposeful arrangements, with increase in service volumes, innovations albeit less standardised quality of care. The pathway of PPP instigation, rollout and sustaining in South Asia is based on local starting points by sub-national governments, diffusion of practice across states, common interests and shared bureaucratic coalitions. Success drivers include administrative support beyond the health sector, simplified contractual and payment systems providing operational ease and decision space, and the use of relational management and digital monitoring for resolving issues. However, PPPs are constrained by either too little accountability or excessive accountability in contract design, trust deficits between private and government, and fire-walled PPP implementation creates disconnects from national primary care planning and regulation. Donor supported projectized PPP funding and accompanying rules of business makes PPPs implementation more cumbersome. We conclude that future attention must centrally focus on pathways and drivers to impactfully introduce, scale-up and sustain PPPs in South Asia. Emphasis must be on pathways that build on local simplified ideation, progressive adaptation and allowing contextual diversity under a larger UHC planning architecture, as opposed to centralised one-fit and heavily technocratic initiatives. Success drivers must feature in design of PPP initiatives. Furthermore, we contend that international donor assistance should shift from projectized support for PPPs to building public sector competencies for stewardship, private sector engagement skills as well as the more traditional performance management capacity.</p>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081327","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":"Global Burden of Disease Due to High Body Mass Index and Projections to 2040: A Study Based on the Global Burden of Disease Study 2019.","authors":"Eun-Ji Kim, Yoonseo Park, Sewon Park, Mihajlo Jakovljevic, Munjae Lee","doi":"10.1002/hpm.3946","DOIUrl":"https://doi.org/10.1002/hpm.3946","url":null,"abstract":"<p><strong>Background: </strong>The prevalence of high body mass index (BMI) contributes to an increased risk of various diseases. This study aimed to identify global disease burden trends associated with high BMI from 1990 to 2019 and forecasts up to 2040.</p><p><strong>Methods: </strong>Using data from the global burden of disease (GBD) 2019 study, we analysed the number and ratio of disability-adjusted life years (DALYs) related to high BMI. The data were analysed by sex, ages, socio-demographic index (SDI), world health organization (WHO) region, and disease level. The autoregressive integrated moving average (ARIMA) model was employed to predict high BMI-related disease burden up to 2040.</p><p><strong>Results: </strong>In 2019, the global burden of disease due to high BMI was 1932.54 (95% uncertainty interval [UI]: 1276.61, 2639.74), representing an increase of 0.18 (95% UI: 0.02, 0.42). Disease burden was consistently higher in males, middle-aged and older populations, particularly noting a narrowing gap between those aged 50-69 years and≥ 70 years in the forecast results until 2040. Additionally, regions with a middle SDI and the North Africa and Middle East WHO super-regions exhibited the highest disease burdens. Also, Cardiovascular disease ranked highest among diseases.</p><p><strong>Conclusion: </strong>The rising disease burden associated with high BMI highlights the need for targeted health policies focussing on older populations, low and middle-income countries, and major conditions like cardiovascular disease and diabetes. Addressing these trends requires an integrated, equity-focused approach to health planning and management to mitigate global impacts.</p>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081324","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":"Heterogeneous Effects of Decreasing the Cost-Sharing for Outpatient Care on Health Outcomes in China: A Propensity Score Matching and Causal Machine Learning Approach.","authors":"Tao Zhang, Meiteng Yu, Yang Song, Jing Liu","doi":"10.1002/hpm.3938","DOIUrl":"https://doi.org/10.1002/hpm.3938","url":null,"abstract":"<p><strong>Background: </strong>To improve accessibility and financial support for outpatient services, China introduced a scheme to decrease cost-sharing for outpatient care under the Urban Employee Basic Medical Insurance. This study evaluates the health impacts of this policy and examines its heterogeneous effects.</p><p><strong>Methods: </strong>Utilising data from the 2018 China Health and Retirement Longitudinal Study, we analysed 2896 individual-level observations across 105 prefectures. Propensity score matching and a causal forest model were applied to evaluate the effects on chronic disease status, body pain, self-rated health, and hospitalisation, while accounting for various demographic, socioeconomic, residential, health-related behaviours, and prefecture-specific factors.</p><p><strong>Results: </strong>The reduction in cost-sharing was significantly linked to decreased probabilities of chronic disease (Average Treatment Effect (ATE) = -0.0619, p < 0.01), body pain (ATE = -0.0715, p < 0.05), and hospitalisation (ATE = -0.0592, p < 0.001), as well as improved self-rated health (ATE = 0.1557, p < 0.001). These benefits may be attributed to reduced out-of-pocket payments for outpatient care (ATE = -287.6112, p < 0.01) and increased outpatient visits (ATE = 0.0414 visits, p < 0.05). Causal forest analyses revealed that older individuals, those with higher educational attainment, higher household income, urban residents, and those engaging in healthier behaviours exhibited larger treatment effects.</p><p><strong>Conclusions: </strong>Decreasing outpatient cost-sharing in China has beneficial health outcomes, with variations in its impact based on socio-economic status and health behaviours. It is advisable to further increase reimbursement rates and broaden benefit packages for outpatient care, while addressing the unequal distribution of benefits.</p>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054026","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":"Understanding Children's Daily Approach to Their Food Culture: A Microsocial Study in a Marginalised Mexico City Neighbourhood.","authors":"Florence L Théodore, Clara Juárez-Ramírez, Sandra Rosales-Galindo, Diana Laura Reartes Peñafiel, Moisés Salazar-Sánchez, Jerónimo Monroy Figueroa, María Ángeles Villanueva-Borbolla, Laura Elena Corona de la Peña","doi":"10.1002/hpm.3937","DOIUrl":"https://doi.org/10.1002/hpm.3937","url":null,"abstract":"<p><strong>Objective: </strong>The aim of the research presented in this article was to understand children's daily approach to food in a marginalised neighbourhood of Mexico City as a proximal determinant of health to help improve the design of health and food services and programmes that support children in food insecure conditions.</p><p><strong>Method: </strong>A qualitative-ethnographic study was conducted by a multidisciplinary team. Data collection involved various methods and techniques: revision of secondary sources; ethnographic observation; individual interviews with key actors; focus group with the children's parents/caregivers; information generated by 30 children through drawings, collective activities, and spontaneous comments related to food during 10 workshop sessions.</p><p><strong>Results: </strong>Our research sheds light on the intricate ways of children's perception and engagement with food and food culture in their everyday lives. Through firsthand accounts from people within children's immediate circles, we gained insight into the multifaceted dynamics shaping food preferences and the family's challenge to access nutritious options considering time constraints and scarce financial resources.</p><p><strong>Conclusion: </strong>Effective food governance must consider how the history of territories has shaped people's food preferences, as well as understand the constraints of children's families in bringing about changes in food choices. There is a need to improve communication between managers and planners of health services and social programmes for children.</p>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144064978","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":"Application of Deliberative Democracy Processes in the Healthcare Setting to Determine Optimal Anal Cancer Screening Processes at a Ryan White Clinic.","authors":"Riya Goel, Ghiara Lugo Diaz, Laura Gaydos, Nadi Kaonga, Lisa Flowers","doi":"10.1002/hpm.3942","DOIUrl":"https://doi.org/10.1002/hpm.3942","url":null,"abstract":"<p><strong>Introduction: </strong>Stakeholder deliberation (SD) methodology can be used to facilitate rapid consensus building around clinical decisions in healthcare settings. This study applied SD methodology to complex decisions around screening methods for human papillomavirus (HPV)-related anal high-grade squamous intraepithelial lesions, which are precursors to anal cancer. Adherence to screening guidelines is crucial for early detection but implementing new anal cancer screening (ACS) guidelines requires robust infrastructure and collaboration across healthcare teams. This study offers an example of SD implementation processes that can be used effectively in complex healthcare settings.</p><p><strong>Methods: </strong>Three stakeholder meetings were conducted with 7 and 8 participants each, focussing on specific ACS topics. For each topic, participants reviewed background information and considered two alternatives. An initial vote was followed by group discussions to generate a comprehensive list of pros and cons for each alternative, additional deliberation, and a final vote to reach a minimum consensus threshold of 80%.</p><p><strong>Results: </strong>Seven to eight participants attended each deliberation. Key issues addressed included anal cytology documentation, co-testing with HPV, and histological sample documentation. Consensus levels reached 80%, 100%, and 100% respectively indicating a high level of agreement on decisions reached and suggesting a high likelihood of successful implementation and acceptance.</p><p><strong>Conclusion: </strong>SD methodology effectively facilitated consensus on the process for implementing ACS guidelines, demonstrating its utility in clinical settings. Decision-makers may consider adopting SD processes to streamline guideline implementation and optimise patient care across disease areas and clinical settings.</p>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144030386","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":"How Private Health Insurance Shapes Perceptions of Public Healthcare in Sweden.","authors":"Linn Kullberg, Paula Blomqvist, Ulrika Winblad","doi":"10.1002/hpm.3941","DOIUrl":"https://doi.org/10.1002/hpm.3941","url":null,"abstract":"<p><p>The increasing prevalence of private health insurance (PHI) in tax-funded healthcare systems challenges the principles of equity and universalism. A significant proportion of PHI holders in such systems receive their insurance as an employment benefit, granting them access to privately funded healthcare alongside the publicly funded system. This dual access raises critical questions about how individuals navigate between the two sectors and how their experiences shape their perceptions of public healthcare. The aim of this study is to explore how the use of PHI-funded healthcare services influences perceptions of and satisfaction with the public healthcare system. Specifically, we examine when PHI holders choose privately funded care over public services, how they perceive the two sectors, and whether they would purchase PHI independently if it were not offered as an employment benefit. An interview study was conducted in 2022 with 19 individuals in Sweden who receive PHI as an employment benefit. Using thematic analysis, the findings reveal a preference for privately funded services due to faster access and higher service quality. However, the medical quality of specialised care in the public sector is still regarded as high. PHI is perceived as providing a sense of security through prompt care, but few respondents expressed a willingness to purchase it privately, suggesting it is seen more as a convenience than a necessity. These findings highlight the role of PHI in shaping expectations and satisfaction within tax-funded healthcare systems, offering insights into its potential impact on public trust and support of universal healthcare.</p>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143989384","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 Multi-Sector Mixed Methods Study of Stroke Services in the Philippines: Insights From Government Officials and Organisational Leaders.","authors":"Sarah Buckingham, June Ann De Vera, Lorraine Faeldon, Bridie Kent, Angela Logan, Aira Ong, Nena Marie Santos, Paula Melizza Valera, Jonathan Marsden","doi":"10.1002/hpm.3939","DOIUrl":"https://doi.org/10.1002/hpm.3939","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to illustrate the state of stroke care and rehabilitation in the Philippines through the perspectives of local government officials, policymakers, and organisational leaders. It sought to identify challenges, opportunities, and recommendations for improving stroke policies and services across different administrative levels.</p><p><strong>Methods: </strong>Mixed-methods approach involving a structured survey of 131 local government officials and in-depth interviews with eight key stakeholders. Survey participants included Department of Health (DoH) officials, local chief executives, policymakers, Local Government Unit (LGU) employees, and representatives from non-government agencies. Interviewees comprised leads and managers from the DoH and representatives from organisations including the Philippine Academy of Rehabilitation Medicine (PARM), Physicians for Peace Philippines, and the Philippine Council for Health Research and Development (PCHRD). Quantitative survey data were analysed using descriptive statistics and qualitative interview data were thematically analysed, then the two types of data were triangulated and organised by theme.</p><p><strong>Results: </strong>Findings revealed significant gaps in funding, healthcare infrastructure, and policy implementation. Challenges included inadequate facilities, lack of qualified staff, financial barriers, and regional disparities in service provision. Survey and interview participants emphasised the need for increased government support, comprehensive policies, and community-based rehabilitation (CBR) programmes. Improving stroke survivors' quality of life was ranked as the most critical aspect of rehabilitation programmes.</p><p><strong>Conclusions: </strong>The study highlights the critical need for more equitable and accessible stroke care and rehabilitation in the Philippines. This can be facilitated by sustained government support, inter-agency collaboration, community engagement, and the implementation of holistic, evidence-based, and cost-effective CBR initiatives.</p>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144041949","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 Public Health Response to Economic Warfare.","authors":"Martin McKee, Christina Pagel, Tiago Correia","doi":"10.1002/hpm.3940","DOIUrl":"https://doi.org/10.1002/hpm.3940","url":null,"abstract":"<p><p>President Trump's 2025 implementation of tariffs has been described as a form of economic warfare. The public health community has long viewed conventional forms of warfare as a determinant of health and developed appropriate responses. In this editorial, we argue that this community must now respond in a similar way to all forms of economic warfare. We describe the ways in which economic warfare is waged, which include tariffs, trade sanctions, currency manipulation, and cyberattacks, and the health consequences that arise from them. Drawing on historical examples like the Opium Wars, we highlight the intertwined nature of economic and military conflicts. We also describe how advances in technology have created new opportunities, such as the exclusion of Russia from the SWIFT payment system. The health consequences are profound, with research indicating declines in life expectancy and disruptions in access to essential medicines and equipment. We argue for a comprehensive public health response, made urgent by the rejection, by the current U.S. administration, of the post-war international order. We call for use of innovative research methods to assess the health impacts of economic measures, drawing parallels with studies on the health effects of military conflicts and economic crises and advocacy for a proactive public health stance, akin to the efforts of organisations like the International Physicians for the Prevention of Nuclear War, to make visible the health consequences of economic warfare and help those who seek to hold governments accountable for their actions.</p>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144041951","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 Shock Effect: How U.S. Global Health Policy Shifts Reshape Health Systems and Research.","authors":"Wesam Mansour, David Bishai, Irene Torres, Shehla Zaidi, Valéry Ridde, Tiago Correia","doi":"10.1002/hpm.3936","DOIUrl":"https://doi.org/10.1002/hpm.3936","url":null,"abstract":"<p><p>The United States (U.S.) has long played a central role in shaping global health governance, supporting United Nations agencies and funding vital programs and initiatives. However, recent political shifts, including, funding cuts, changing geopolitical priorities and a retreat from multilateralism, are threatening the stability of global health systems and research. This editorial examines the cascading consequences of these shifts, particularly for low- and middle-income countries (LMICs). The U.S. withdrawal is not just a budgetary adjustment, but a significant political disruption with unforeseen effects on global inequities. It also redirects research priorities towards security-driven agendas and undermines capacity-building efforts in LMICs. As the U.S. steps back, new actors will try to fill the vacuum, but the direction of this transition remains uncertain. Whether it paves the way for a more decentralised and equitable global health research ecosystem will depend on how global health stakeholders respond. Crucially, LMICs must seize this moment not only to replace lost funding, but to assert greater autonomy, reimagine health systems financing and build more sustainable, locally led models of research and policy leadership. This editorial calls for urgent diversification of funding sources, strengthened South-South collaborations and increased autonomy for LMICs in setting their own research priorities.</p>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144051985","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 the Digital Economy on Health Inequality: Micro Evidence From China.","authors":"Qingyun Zhao, Yusong Li","doi":"10.1002/hpm.3931","DOIUrl":"https://doi.org/10.1002/hpm.3931","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;In the context of China's goal of pursuing health equity and the economic context of the booming digital economy, it is important to analyse whether the digital economy has mitigated income-related health inequality and how it works.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;By matching urban macro-data with individual micro-data, the study obtains mixed panel data at the individual level for five periods from 2012 to 2020. The entropy method is used to comprehensively measure both the level of urban digital economy development and residents' health. The concentration index method was used to measure the extent of health inequality between residents at different income levels. Furthermore, the study uses the recentered influence function (RIF_CI_OLS) regression model to empirically test the impact of the digital economy on health inequality and its underlying mechanisms.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;We found that, first, the digital economy significantly alleviates health inequality among groups with different income characteristics, by providing year-by-year insights into the contribution of the digital economy to health inequality, we find that the digital economy plays a significant and positive long-term role in promoting health equity. Second, a mediated effects model is used to test the mechanisms by which the digital economy mitigates health inequality. The results show that the digital economy reduces health inequality between groups with different income characteristics by increasing the accessibility of healthcare services to the population. Third, there is obvious regional and individual heterogeneity in the impact of the digital economy on health inequality. The digital economy has a greater mitigating effect on health inequality among residents of urban, eastern, and central regions. The impact of the digital economy on health inequality does not show significant heterogeneity in terms of gender, but there is a significant differential effect in terms of age, with the digital economy significantly alleviating health inequality in the 45-60 years old group, and the effect on the other age groups is statistically significant. Overall, the digital economy plays a significant positive role in narrowing health inequality among different income groups. Although its facilitating effect is relatively weak in regions with underdeveloped digital economies, in the long term, as digital technology improves, the inclusive effect of the digital economy will gradually emerge, promoting the equitable sharing of health benefits among various groups and thereby further promoting health equity.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Strengthening digital infrastructure, promoting the development of the digital health industry, and improving the digital literacy of the population-especially by increasing digital support for less-developed regions such as the west and rural areas, as well as for disadvantaged groups such as those wi","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144034418","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}