International Journal of Health Planning and Management最新文献

{"title":"Applying Corporate Well-Being Strategies to Medical Practice: Addressing Physician Burnout and Overwork.","authors":"Sakumi Yamakawa, Maaya Ono, Kiyonobu Kusu, Hayase Hakariya","doi":"10.1002/hpm.3928","DOIUrl":"https://doi.org/10.1002/hpm.3928","url":null,"abstract":"<p><p>In August 2023, a tragic case in Kobe City, Japan, highlighted the severe working conditions faced by resident physicians. A resident specialising in internal medicine died by suicide after experiencing extraordinary workloads, including 236 h of overtime in the month before his death. This case underscores the broader systemic issue of excessive working hours in Japan's medical profession, exacerbated by the country's 'passion pay' culture, which exploits young physicians' dedication. Surveys indicate that 28% of residents experience burnout, with long hours, inefficient task allocation and poor workplace communication as key stressors. Addressing excessive workloads requires restructuring physician responsibilities. Research shows that full-time physicians under 50 spend significant time on non-medical tasks that could be delegated to other professionals. The primary physician model, which holds doctors responsible for patients beyond their shifts, further extends work hours. Transitioning to a time-based task allocation system and implementing task-shifting strategies could alleviate these burdens. Workplace communication also requires improvement. Limited supervisory support and hierarchical barriers prevent open discussions about well-being. We underscore that drawing insights from corporate strategies, such as Marui Group's task optimisation policies and TOYOTA's anonymous feedback system, hospitals could implement structured well-being initiatives for physicians. Physician well-being directly correlates with patient satisfaction and treatment adherence. Addressing burnout through workload reduction and improved communication is essential for maintaining both doctor and patient health. Hospitals must prioritise physician well-being alongside patient care, fostering a sustainable working environment for medical professionals.</p>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639681","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 Shadow Pandemic Contextualised: Albania's Response to Domestic Violence During COVID-19.","authors":"Venera Bekteshi, Mary van Hook, Eglantina Gjermeni, Jenn L Bellamy","doi":"10.1002/hpm.3884","DOIUrl":"https://doi.org/10.1002/hpm.3884","url":null,"abstract":"<p><strong>Background: </strong>Domestic violence (DV) encompasses a pattern of psychological, physical, sexual, financial, and/or emotional abuse, manifesting through assault, threats, and intimidation. Economic and social stressors in conjunction with the COVID-19 pandemic escalated DV cases worldwide, including those in Albania. Socioeconomic vulnerabilities worsened the situation, with DV-related complaints to non-governmental organizations (NGOs) in Albania increasing by 60% between March and May 2020, compared to the same period in 2019. Despite government efforts through a comprehensive anti-DV strategy, as the pandemic subsided, 2986 Albanian women still reported enduring DV.</p><p><strong>Methods: </strong>Using the Contextual Influence in Acculturative Stress (CIAS) framework, this study identified key external and internal contextual factors contributing to DV in Albania. These factors were assessed to evaluate their integration into the national anti-DV policy and their potential for improving the policy's impact.</p><p><strong>Results: </strong>The Albanian government's response focused on four primary areas: legal protection, women's safety, economic well-being, and community awareness. However, many vulnerable groups remained underserved. Furthermore, economic assistance provided was insufficient to address the increased financial strain faced by victims. Educational and awareness campaigns were implemented, but despite these efforts, DV rates persisted at high levels throughout the pandemic.</p><p><strong>Conclusion: </strong>The findings underscore the need for more targeted, comprehensive, and context-sensitive approaches to DV intervention. The Albanian government's anti-DV strategy could be strengthened by addressing micro-level needs, such as tailored counselling, culturally sensitive services, and more robust economic support measures. Incorporating these elements into future policies may better address the structural and cultural barriers that perpetuate DV, particularly among vulnerable populations.</p>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617210","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":"Artificial Intelligence in Healthcare: Balancing Technological Innovation With Health and Care Workforce Priorities.","authors":"Abi Sriharan, Ellen Kuhlmann, Tiago Correia, Farhang Tahzib, Katarzyna Czabanowska, Marius-Ionuț Ungureanu, Bernadette Nirmal Kumar","doi":"10.1002/hpm.3927","DOIUrl":"https://doi.org/10.1002/hpm.3927","url":null,"abstract":"<p><p>Artificial Intelligence (AI) has emerged as a transformative force in healthcare, offering significant potential to address workforce challenges and improve patient outcomes. This perspective article presents a framework for responsible AI innovation, emphasising ethical governance, responsible leadership and a commitment to human-centred AI. It provides guidance for healthcare organisations to position AI as a strategic enabler, augmenting the health and care workforce and fostering sustainable, patient-centred advancements in healthcare.</p>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617208","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":"Access to Healthcare Among Tribal Population in India: A Cross-Sectional Household Survey.","authors":"Yogita Sharma, Parikipandla Sridevi, Deepa Bhat, Shaily B Surti, Jatin Sarmah, Godi Sudhakar, Manoranjan Ranjit, Bontha V Babu","doi":"10.1002/hpm.3924","DOIUrl":"https://doi.org/10.1002/hpm.3924","url":null,"abstract":"<p><p>This study addresses significant healthcare access challenges faced by India's 104 million-strong tribal population, who are among the most disadvantaged and typically live in hilly rural and remote areas with poor health infrastructure and resources. The study aims to examine healthcare access patterns in six tribal areas, focussing on primary health centres (PHCs), to develop a strategy that improves healthcare service accessibility, quality, and utilization for tribal communities. Data were collected from 9837 participants from 24 PHC areas across six states. Most respondents (78.8%; CI: 77.98-79.61) reported monthly visits of government health workers to their habitations, indicating regular healthcare access. Two-thirds confirmed house visits in the last 3 months, primarily receiving immunisation services. A significant portion (57.38%; CI: 56.39-58.36) received health education, and a majority (64.29%; CI: 63.33-65.24) were satisfied with the services. About 77% depend on PHC and its healthcare staff, though state-wise variations exist. Common reasons for not using these services included distance (17.45%; CI: 16.71-18.22) and lack of trust (4.57%; CI: 4.17-5.01). Most respondents were examined by a doctor (60.32%; CI: 59.35-61.29) and received diagnostic tests (27.50%; CI: 26.62-28.39). Walking (21.88%; CI: 21.6-22.71) and auto-rickshaw/cab (20.23%; CI: 19.44-21.04) were the most common travel modes, with a mean travel time of 34 min. The data highlights the tribal population's preferences and experiences with primary healthcare services. Understanding these patterns can guide the design implementation research to further improve accessibility and utilisation of primary healthcare services among these vulnerable populations.</p>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606666","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":"Securing Global Health in the Face of Changing U.S. Policy: The Case for Strengthening National Public Health Institutes.","authors":"Quentin Sandifer, Duncan Selbie, Sadaf Lynes, Neil Squires","doi":"10.1002/hpm.3925","DOIUrl":"https://doi.org/10.1002/hpm.3925","url":null,"abstract":"<p><p>Following the announcement by the new American administration of a pause and review of funding to international aid programmes, we comment on the potential effect on global health security and argue for increased recognition of the role of National Public Health Institutes (NPHIs) to mitigate the impacts.</p>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606668","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":"Establishing Sustainable Access to Quality Uterotonics in Kano, Lagos and Niger States-A Supply Chain Perspective.","authors":"Eba Ajima, Chukwunonso Nwaokorie, Naanma Kangkum, Lola Ameyan, Obruche Sophia Ogefere, Eric Aigbogun, Valentine Amasiatu, Uchenna Igbokwe","doi":"10.1002/hpm.3910","DOIUrl":"https://doi.org/10.1002/hpm.3910","url":null,"abstract":"<p><strong>Background: </strong>The quality of oxytocin and misoprostol, the most widely used uterotonics for postpartum haemorrhage (PPH) management, suffer supply chain challenges and climactic susceptibilities.</p><p><strong>Aim: </strong>To describe a supply chain strengthening programme for introducing heat-stable Carbetocin (HSC), to health facilities in Kano, Lagos and Niger states.</p><p><strong>Method: </strong>Human-centred design (HCD) was employed to uncover uterotonics supply chain challenges and to identify priority interventions across a market-shaping value chain to facilitate the rollout of HSC. Through a mixed-methods approach and interviews with 203 stakeholders, challenges in the uterotonics supply chain and potential solutions were identified. A market-shaping value chain was employed to map HSC introduction and rollout, focusing on key interventions. Before the project initiation, we established clear objectives including identifying barriers, introduction and rollout journey mapping of HSC.</p><p><strong>Results: </strong>Using HCD, HSC was successfully rolled out to over 87 health facilities. Employing the market-shaping value chain, pivotal interventions were executed. These included policy updates (inclusion of HSC in the National and States Essential Medicines List), regulatory actions (registering Carbetocin with NAFDAC), financing strategies (co-developing state roadmaps for sustainable procurements), supply management (reducing stock-outs) and healthcare provider training on supply chain management practices. These efforts facilitated seamless integration of HSC into the states' supply chains.</p><p><strong>Conclusion: </strong>HCD and market-shaping value chain approach were employed to introduce HSC in Nigeria. This study shows that integrating these approaches can enhance the availability and accessibility of essential medicines, offering potential replicability in similar health systems.</p>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143597551","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":"Counting Midwives Providing Clinical Care in Nevada.","authors":"Jennifer Vanderlaan, Janice Enriquez, Melva Thompson-Robinson","doi":"10.1002/hpm.3921","DOIUrl":"https://doi.org/10.1002/hpm.3921","url":null,"abstract":"<p><strong>Objective: </strong>To estimate the number of midwives providing care primarily in Nevada.</p><p><strong>Study setting and design: </strong>A cross-sectional study of Nevada was conducted in May, 2024 to compare the agreement between two lists of midwives in Nevada. Midwives were considered as providing care primarily in Nevada if they (1) had an active licence with a Nevada address and (2) listed a Nevada practice site in their National Provider Identifier file.</p><p><strong>Data sources and analytic sample: </strong>The sample of midwives associated with Nevada was created by combining (1) the State Board of Nursing list of nurse-midwife licensees and (2) the National Plan & Provider Enumeration System Data Dissemination file enumerates identified as advanced practice midwives with a Nevada licence or practice location in Nevada.</p><p><strong>Principle findings: </strong>Only 55% of nurse-midwives with active Nevada licences are providing care full-time in Nevada.</p><p><strong>Conclusions: </strong>Nurse-midwife licensee lists may overstate the number of nurse-midwives practicing full-time in the state. States may consider nurse licence compacts with registration for telehealth or hub-and-spoke models of care to identify the extent to which out-of-state midwives are filling gaps in access to care.</p>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574267","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":"Long-Term Limiting Illness in the United Kingdom: Before and After the Covid Lockdown.","authors":"Vani K Borooah, Colin G Knox","doi":"10.1002/hpm.3920","DOIUrl":"https://doi.org/10.1002/hpm.3920","url":null,"abstract":"<p><p>The purpose of this paper is to study the evolution of LTLI in the UK between the pre- and post-Covid years of, respectively, 2019 and 2022 paying attention to differences in the propensity to LTLI between different subgroups of the population in each of the two years and then examining whether the propensity to LTLI changed between the years, both in respect of overall change and in respect of the separate population subgroups. This was achieved using UK Labour Force Survey data for 2019 and 2022. In terms of the social gradient to health, persons in the Managerial/Professional classes had a significantly higher PP (predicted probability) of N-LTI (i.e., of not having a long-term illness) than persons either in the Routine non-Manual or Routine Manual classes and also had a significantly lower PP of LTLI-lot (i.e., of having a long-term illness which limited activity by a lot) than persons either in the Intermediate or in the Routine Manual or Routine non-Manual classes. This was true in both 2019 and 2022. In other words, there was significant inequality in the PP of LTLI associated with the occupational classes. In terms of changes in the propensity to LTLI, the PP of having a long-term illness-regardless of whether it was limiting or not - was significantly higher in 2022 than it was in 2019 both for the overall population and for its subgroups.</p>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558313","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":"Enhancing Learning Systems in Using Patient Experience Data: An Exploratory Mixed-Method Study in Two Italian Regions.","authors":"Elisa Peruzzo, Milena Vainieri, Sabina De Rosis","doi":"10.1002/hpm.3912","DOIUrl":"https://doi.org/10.1002/hpm.3912","url":null,"abstract":"<p><p>In the quest for healthcare systems enhancement, the improvement of patient experience plays a central role. The challenge lies in converting patient-reported experience data into actionable knowledge for quality improvement. This study aims to investigate the use of patient-reported data as knowledge base for actions and to identify and map actions derived from the use of patient-experience data within two Italian regional healthcare systems. Patient Experience Data are systematically collected in both systems, providing real-time updates accessible by professionals and managers through web-based reporting systems and including a collaborative network among practitioners. A sequential exploratory mixed-method study was carried out in several qualitative and quantitative phases. In the first phase, a qualitative method was conducted to discuss the actionability of patient-reported data and to design a tool for collecting the improvement actions based on these data. In the second phase, a quali-quantitative survey was performed to explore the professionals' use of patient-reported information and the types of actions implemented. Finally, a workshop was held to discuss, interpret and validate the results. The initial workshop identified key dimensions for improvement initiatives. After design and distribution of survey, a total of 189 responses was collected, respectively 96 from Region A and 93 from Region B. Both regions ensured widespread use of patient-reported data (89%). The establishment of a collaborative network seemed to reduce the learning curve in using patient-reported data and fostered a culture of using patient feedback effectively. The results reveal a difference between the two regions, with a more extensive patient-reported data use in Region A, attributed to its systematic joining the PREMs Observatory, prior experiences with patient-feedback collection and use, and patient-experience indicators integrated into the performance evaluation system. Regarding practices of data use, four themes emerged, namely, internal actions addressed to hospital staff (35.9%), external actions addressed to users (18.6%), comfort and hospitality aspects (34.7%) and review of processes and procedures (10.8%). The study highlights the importance of effectively using patient-reported data to achieve organisational goals, by combining different managerial strategies. It demonstrates how professionals use such data for improvement actions and underscores the significance of various forms of knowledge dissemination and sharing. It advocates for fostering a culture of continuous learning and improvement within and across healthcare organisations.</p>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494181","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 Infrastructure of a Canadian Rural Health Network: A Four-Year Longitudinal Survey Study.","authors":"Anshu Parajulee, Gal Av-Gay, Tom Skinner, Jude Kornelsen","doi":"10.1002/hpm.3898","DOIUrl":"https://doi.org/10.1002/hpm.3898","url":null,"abstract":"<p><strong>Background: </strong>Formal networks are increasingly being used as a strategy to address complex health system issues. This study aimed to understand the organisational performance of a novel network, the Rural Surgical and Obstetrical Networks (RSON) in the Canadian province of British Columbia, as it developed and grew over four years.</p><p><strong>Methods: </strong>Between 2019 and 2022, we administrated an annual 37-item survey on network organisational aspects with RSON leaders. We calculated the percentage of favourable ratings (four or five rating out of five) for each survey item and used a two-tailed Wilcoxon Mann-Whitney rank sum test to compare ratings over time. Key themes in respondent comments were described narratively.</p><p><strong>Results: </strong>Over four years, we distributed 114 survey invitations to RSON leaders and received 77 responses. From 2019 to 2022, 24 out of 37 survey items (65%) had a statistically significant increase in ratings. Ratings and comments indicated that RSON could have improved its function by (a) including more peripheral network members in decision-making and (b) formalising structures and processes for some network areas. Findings also indicate the presence of three network tensions within RSON: inclusiveness versus efficiency, stability versus flexibility, and network operations versus health system operations.</p><p><strong>Conclusion: </strong>Study findings validate and build on existing network theories and provide practical learnings for other jurisdictions interested in implementing a network like RSON. Among the tensions identified within RSON, the network operations versus health system operations tension, specific to a healthcare delivery setting, has not been well described previously.</p>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143504819","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}