International Journal of Health Planning and Management最新文献

{"title":"Healthcare Resilience Should Include the Worker-Patient Safety Loop: A Taiwan Psychiatric Hospital Perspective.","authors":"Lien-Chung Wei, Chun-Hung Lee","doi":"10.1002/hpm.70130","DOIUrl":"https://doi.org/10.1002/hpm.70130","url":null,"abstract":"<p><p>Research before and during COVID-19 has framed health-system resilience as the capacity to absorb shocks, adapt, transform and learn while sustaining essential functions. Building on this broader literature, including Meredith et al.'s account of local public-health adaptation under political and resource constraints, we propose a worker-patient safety loop from a Taiwan psychiatric hospital perspective: workforce strain can weaken safety-critical care; near misses, adverse events and continuity failures should trigger reporting, organisational learning and corrective action; and the resulting changes should protect workers, patients and care continuity. The loop can be monitored through indicators of workforce wellbeing and safety, safety-event learning, and continuity across settings, supported by digital incident, staffing and handoff systems with safeguards for privacy and data quality. Informed by professional experience and published evidence, this conceptual framework applies to acute shocks and continuing operational pressures. Its proposed domains require prospective empirical validation before they can be treated as established measures of hospital resilience.</p>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148799485","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":"Reimbursement Design and Procedure-Level Gross Profit of Robot-Assisted Gastrectomy in a Publicly Financed Health System: Evidence From Japan.","authors":"Yoshimasa Akashi, Koichi Ogawa, Yohei Owada, Tsuyoshi Enomoto, Kinji Furuya, Kazuhiro Takahashi, Osamu Shimomura, Yoshihiro Miyazaki, Tatsuya Oda","doi":"10.1002/hpm.70127","DOIUrl":"https://doi.org/10.1002/hpm.70127","url":null,"abstract":"<p><p>Publicly financed healthcare systems must balance technological innovation with fiscal constraints. Reimbursement mechanisms influence institutional decisions regarding the adoption of high-cost surgical technologies. This study evaluated whether current reimbursement designs adequately reflect procedure-level gross surgical profit of robot-assisted gastrectomy within the Japanese National Health Insurance system. A retrospective cost analysis was conducted for curative gastric cancer surgery performed at a tertiary institution in 2024. Gross surgical profit was defined as total reimbursement minus procedure-related costs, including consumables, robot maintenance, and labour costs. Postoperative complication-related costs and total episode-of-care costs were not incorporated into the analysis. Fifty-two gastrectomies were analysed. Open and laparoscopic distal gastrectomy generated positive gross profits, whereas robotic distal gastrectomy resulted in a negative gross margin (-¥87,075 per case). Although robotic total gastrectomy showed a positive gross profit in absolute terms, it remained substantially less profitable than open total gastrectomy. Increased procedure-related costs associated with robotic surgery were only partially offset by higher reimbursement. Sensitivity analyses indicated that gross profit was more responsive to changes in surgical fees and material costs than to maintenance or labour costs. These findings suggest that current reimbursement increments may not fully reflect procedure-related costs associated with robotic gastrectomy and highlight the importance of procedure-specific reimbursement evaluation when introducing high-cost surgical technologies into publicly financed healthcare systems.</p>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148764099","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 Domestic Public Health Spending on Health Outcomes in Sub-Saharan Africa: Evidence From Disability-Adjusted Life Years.","authors":"Wa Ntita Serge Kabongo, Josue Mbonigaba","doi":"10.1002/hpm.70104","DOIUrl":"10.1002/hpm.70104","url":null,"abstract":"<p><p>Sub-Saharan Africa (SSA) continues to experience a high and uneven disease burden, mainly from HIV/AIDS, tuberculosis, and malaria. As external funding declines, the strategic allocation of domestic public health spending (DPHS) becomes crucial. This study assesses whether directing DPHS towards major diseases and high-burden areas improves health outcomes across 43 SSA countries between 2003 and 2022, using DALYs as the outcome measure. Results show a statistically significant positive relationship between DPHS and DALYs: HIV-specific models yield coefficients of 0.105-0.288 (p < 0.01), and all-cause models yield coefficients of 0.071-0.085 (p < 0.05), while other models are insignificant. The paradoxical positive association-stronger in high-burden settings-suggests that DPHS is reactive, mainly used to address existing disease burdens rather than prevent them. The significant persistence of DALYs, especially in low-burden and high-burden contexts, further indicates that spending is directed towards treatment and case management rather than preventive measures. The DPHS effect on tuberculosis or malaria outcomes in DALYs is slightly greater in low-burden areas. Beyond health spending, factors such as economic growth, inequality, population ageing, and governance substantially influence health outcomes. Overall, the findings highlight that while DPHS remains essential, its current reactive deployment limits effectiveness. A systemic shift is needed towards proactive, preventive approaches with targeted health interventions to reduce the region's disease burden.</p>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148726209","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":"Efforts to Prevent the Neglect of Traditional Indigenous Medicine: Policy Insights From Bolivia.","authors":"Carlos Rosas-Jiménez, Roberto Tola, Melina Flores, Sonia Cruz, Gonzalo Huanca, Cynthia Lokker, Bonny Ibhawoh, Lisa Schwartz","doi":"10.1002/hpm.70126","DOIUrl":"https://doi.org/10.1002/hpm.70126","url":null,"abstract":"<p><p>Traditional Indigenous medicine has existed for centuries, but only recently has it obtained international recognition. Some countries have been working on the integration of traditional Indigenous healing practices in their national health systems. For example, Bolivia has taken significant steps to prevent the neglect of traditional Indigenous medicine over the last 40+ years, a process that continues today through several policies supported by the national government. The aim of this perspective article was to discuss efforts to prevent the neglect of traditional Indigenous medicine in Bolivia. Through analysis of 12 legal documents, including the Constitution of 2009, decrees, laws and resolutions, we categorised the efforts in 5 points: acknowledging the past, making radical changes to the political constitution, adopting a new approach to health and wellness, regulating traditional medicine, and protecting the environment.</p>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148714002","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":"Mapping System Vulnerabilities in Anaesthesia Safety: A Role-Based Inquiry in Response to Fatal Fungal Meningitis Outbreaks in Mexico.","authors":"Jonathan Matías Chejfec-Ciociano, Adrian Orozco Guridi, Gerardo Prieto Hurtado, Maryam Tabibzadeh, André van Zundert, Adrian W Gelb, Paul Barach","doi":"10.1002/hpm.70125","DOIUrl":"https://doi.org/10.1002/hpm.70125","url":null,"abstract":"<p><strong>Objectives: </strong>Unsafe anaesthesia practices in Mexico have contributed to repeated outbreaks of fatal fungal meningitis, exposing broader health system vulnerabilities. This study aimed to analyse how structural weaknesses in perioperative care, spanning governance, workforce, and institutional practices, reflect deep gaps in health planning, regulation, clinical oversight and hospital management.</p><p><strong>Methods: </strong>We applied a participatory, role-based systems mapping approach. A two-phase design method combined a survey to identify perceived system failures with structured, guided interprofessional, participatory reflection sessions. Participants from diverse professional groups refined key themes and assessed their impacts on patient safety, workforce practice, and institutional integrity.</p><p><strong>Results: </strong>Four core themes emerged: resource management and operational efficiency; quality control and safety standards; regulatory compliance and institutional integrity; and personnel commitment and professional conduct. Beyond resource and regulatory gaps, the findings highlighted weak institutions, fragmented communication, and improvised workarounds normalised across professional groups. These patterns underscore system-wide deficiencies in national policy and system strategy implementation, health workforce planning, operational management, and organizational accountability.</p><p><strong>Conclusions: </strong>Catastrophic fungal, fatal meningitis outbreaks in Mexico arose from failures of governance, learning, oversight, culture, supply chains, and frontline practice-and prevention requires coordinated action across the entire sociotechnical system. By situating perioperative safety failures within the broader context of health-system governance, this study demonstrates the value of participatory systems inquiry for linking frontline clinician experiences to policy and organizational priorities. The findings provide a foundation for strategies to strengthen health planning, regulatory oversight, and organizational readiness in complex health systems.</p>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148702516","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":"Can Community Be Our Shelter? Exploring the Interaction Among Environmental Pollution, Community Support and Mental Health.","authors":"Xiaojing Xue, Yong Li, Ping Wang","doi":"10.1002/hpm.70117","DOIUrl":"https://doi.org/10.1002/hpm.70117","url":null,"abstract":"<p><p>While individual effects of community support and environmental pollution on mental health have been studied separately, the interplay between these factors has not been extensively explored. This paper investigates the impact of environmental pollution on mental health, with a particular focus on the mediating role of community support, using data from the China General Social Survey (CGSS) conducted in 2021. The results of this study suggest that environmental pollution significantly correlates with poorer mental health outcomes. However, strong community support-encompassing social cohesion, collective efficacy, and resource sharing-ameliorates these negative effects. These findings provide empirical support for the Competence Enhancement Model in the context of China, highlighting the need for policies that integrate environmental management with community-based mental health interventions. Strengthening community resilience and fostering supportive social networks may serve as viable strategies for mitigating pollution's mental health burden.</p>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148670905","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":"Evaluating Sterilization Services in Healthcare: A Multi-Criteria Decision-Making Approach to In-House Versus Outsourced Options.","authors":"Gokhan Agac, Osman Senol, Sedat Bostan, Muhammet Gul","doi":"10.1002/hpm.70122","DOIUrl":"https://doi.org/10.1002/hpm.70122","url":null,"abstract":"<p><strong>Background: </strong>This study investigates whether the management of sterilization services in healthcare facilities should be handled internally or outsourced to an external company. In this context, the aim of the study is to identify factors influencing sterilization services, prioritize them, and rank alternative strategies using multi-criteria decision-making techniques.</p><p><strong>Methods: </strong>We introduce a hybrid method to select the optimal sterilization service for healthcare institutions. This method involves determining criteria and alternatives for sterilization services, collecting data from experts, determining the weights of factors affecting the type of sterilization service using the Bayesian BWM method, and finally identifying the optimal sterilization service using the Fuzzy TOPSIS method. The study is conducted as a real case study at a university hospital in Türkiye. We also conducted a sensitivity and comparative analysis to ensure the robustness and reliability of the proposed decision-making model, and to provide more precise and meaningful outcomes.</p><p><strong>Results: </strong>The results of the study indicate that \"Adaptation to technological developments\" is the most effective criterion for all participants, and outsourcing sterilization services is the dominant view according to the criteria.</p><p><strong>Conclusions: </strong>The study highlights the significance of integrating technological advancements into the management of sterilization services within healthcare facilities. It offers decision-makers a comprehensive framework to make informed choices about sterilization service management, thereby enhancing patient care and operational efficiency in healthcare facilities. Additionally, it offers guidance to decision-makers, enabling them to make more suitable decisions and policies in sterilization service management.</p>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148664653","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-Objective Periodic Vehicle Routing Model for Sustainable Healthcare Waste Collection.","authors":"Hajer Ben-Romdhane","doi":"10.1002/hpm.70112","DOIUrl":"https://doi.org/10.1002/hpm.70112","url":null,"abstract":"<p><p>The collection of infectious waste from healthcare facilities (HCF) constitutes a recurring operational challenge. Indeed, despite the inherent health risks posed by the storage and the transportation of infectious materials, most of the existing waste collection systems tends to prioritise cost optimization and to underaddress the safety dimension. Besides, the collection frequency must be tailored to the waste generation rate of each healthcare facility to avoid delays and inefficiencies. Therefore, it is clear that finding the best collection schedule that guarantees safety within HCF, transportation security, and economic profits is both critical and difficult to achieve. In order to more accurately model the described problem, this study introduces the Sustainable and Load-dependent Periodic Vehicle Routing Problem (S-PVRP). The proposed model aims to optimises three objectives: the travelled distance, the transportation risk and the storage risk. Besides, it is designed in a such a way to trigger the collection when a threshold value is reached. To solve the S-PVRP, we design two solution approaches with very well selected ingredients in order to strike a balance between the exploration and exploitation aspects by reasoning upon multiple objectives. An experimental study is carried out to prove the efficiency of the algorithm on multi-objective optimization. The algorithm is tested on several benchmark instances and evaluated via several performance metrics. Indeed, we have compared the performance of our algorithm against state-of-the-art algorithms. The experimental results showed that the proposed approach MX-GAOPT is very competitive and outperforms the competing algorithms in most cases.</p>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148649540","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":"Harnessing the Potential of LLMs in Hospital Management: Insights Into Medical Data Inquiry.","authors":"Jiaxi Li, Yu Zhang, Jing Zhao, Shengyang He, Danni Li","doi":"10.1002/hpm.70106","DOIUrl":"https://doi.org/10.1002/hpm.70106","url":null,"abstract":"<p><strong>Background: </strong>Considering the rapid expansion of hospital operations and the increasing digitisation of medical data, there is a pressing need for efficient and intelligent methods to process and analyse large-scale medical data.</p><p><strong>Methods: </strong>We integrated the QLoRA algorithm with ChatGLM2-6b, Llama2-7b, and Llama2-13b models, fine-tuning them on a local SQL dataset to optimise query performance. Prompt-Engineering with ChatGPT was further applied for effective SQL execution.</p><p><strong>Results: </strong>Original open-source models showed almost no SQL generation capability (overall EX ≈ 0 for ChatGLM2-6B and Llama2-7B; 0.04 for Llama2-13B). QLoRA fine-tuning substantially improved performance, with QLoRA-Llama2-13B achieving the best results among open-source models (overall EX 0.41 ± 0.030). Proprietary models demonstrated significantly stronger performance. Zero-shot ChatGPT-3.5 achieved moderate accuracy (EX 0.44 ± 0.007), which improved to 0.94 ± 0.017 with few-shot prompting. GPT-4.1 further improved performance, reaching 0.78 ± 0.038 in the zero-shot setting and 0.96 ± 0.011 with few-shot prompting. The few-shot GPT-4.1 results were comparable to those of database engineers (EX 0.97 ± 0.017), with no significant difference (p = 0.42).</p><p><strong>Conclusion: </strong>Fine-tuned LLMs and few-shot GPT-4.1 demonstrate substantial improvements in SQL query execution, providing a robust framework for efficient medical data analysis and informed hospital decision-making.</p>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148649465","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 SPD Model in Cost Control and Management Efficiency of Hemostatic Consumables in Hospitals.","authors":"Yiheng Yang, Yang Liu","doi":"10.1002/hpm.70115","DOIUrl":"https://doi.org/10.1002/hpm.70115","url":null,"abstract":"<p><strong>Background: </strong>Current management of hemostatic consumables is challenged by inefficient inventory control, substantial wastage, and recurrent operational adverse events. The SPD model offers an integrated supply chain approach with strong potential to optimize medical logistics. This study aims to evaluate the impact of the SPD model on cost control and management efficiency in hemostatic consumables.</p><p><strong>Methods: </strong>This retrospective study was conducted at a tertiary (Grade A) cancer hospital. Hemostatic consumables managed under the traditional model (January-December 2023) were compared with those under the SPD model (January-December 2024). The SPD model integrated an information technology platform, IoT-enabled smart cabinets, barcode scanning, and a pay-on-consumption settlement mechanism. T-tests and chi-square tests were used to compare the two groups in cost control metrics, management efficiency scores, staff satisfaction, and the incidence of operational adverse events.</p><p><strong>Results: </strong>In terms of cost control, the SPD model demonstrated statistically significant reductions in monthly average hemostatic material expenditure, requisition frequency, expiration loss rate, and reported loss rate (all p < 0.05). Regarding management efficiency, the SPD model showed significantly higher scores in timely delivery, work efficiency, standardization, supply traceability, waste recovery, delivery satisfaction, and demand forecasting, while achieving significantly lower scores in item issues and operating costs (all p < 0.05). Staff satisfaction surveys revealed significant improvements in operational convenience, clinical reliability, system usability, and overall satisfaction under the SPD model (all p < 0.05). Furthermore, the incidence of all documented operational adverse events was significantly reduced under the SPD model (all p < 0.05).</p><p><strong>Conclusion: </strong>The SPD model facilitates precise, low-loss, and highly efficient control of hemostatic consumables, representing an effective optimization strategy with considerable clinical benefits and significant potential for widespread adoption. Despite limitations including single-center design and a one-year observation period, future multi-center and longitudinal studies are warranted to validate these findings and assess long-term sustainability.</p>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148632245","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}