International Journal of Health Planning and Management最新文献

{"title":"Understanding Determinants of Routine Data Use by the Levels of Health System in Low and Middle-Income Countries: A Scoping Review.","authors":"Bigten Kikoba, Masoud Mahundi, Wilfred Senyoni","doi":"10.1002/hpm.70121","DOIUrl":"https://doi.org/10.1002/hpm.70121","url":null,"abstract":"<p><p>Evidence shows limited use of routine data to support health actions in lower and middle-income countries (LMICs). To address that, there are several ongoing efforts to strengthen routine health information systems which are largely crippled by the fragmented nature of the health system. This scoping review aims to identify the key enablers of routine health data use and examine gaps in the institutionalization of data use practices across different levels of the health system in LMICs. We scoped up four literature sources, that is, PubMed, IEEE Xplore, the Public Library of Science (PLOS), and Google Scholar for the article published between January 2019 and December 2023. Three reviewers independently screened article titles, abstracts, and full text against inclusion and exclusion criteria, following the Arksey and O'Malley and PRISMA framework to guide the review process. We classified our findings into three health system levels: that is facility, district, and national/sector-wide. Out of 380 screened articles, 41 were selected for inclusion, where most of the articles (48.8%), were on the health facility level. The study found that factors influencing the use of routine data vary across health system levels, with human resource capacity and friendly data collection tools being more important at the facility level. In contrast, the availability, and capacity to use analytical tools and governance structures were more reported at the district and national levels. Further, capacity building in health information systems, IT infrastructure, and regular supervision were crucial across all health system levels. We argue for focused interventions to be designed to institutionalise routine data use practices for better healthcare outcomes across health system levels.</p>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148608630","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":"Financial Simulation of Remote Healthcare Implementation Strategies in Türkiye: A Monte Carlo Analysis Based on Specialty-Specific Eligibility.","authors":"Hüseyin Demir, Tuncay Akar, Süleyman Mertoğlu, Serhat Burmaoğlu, Merve Tekinarslan","doi":"10.1002/hpm.70118","DOIUrl":"https://doi.org/10.1002/hpm.70118","url":null,"abstract":"<p><p>The expansion of universal health coverage in Türkiye has intensified pressure on public healthcare providers through high outpatient volumes that strain capacity and financial sustainability. Remote healthcare delivery has emerged as a potential strategy to improve efficiency and access. However, limited evidence exists on how remote outpatient care should be implemented across medical specialties within a universal payer system, or how alternative implementation strategies perform financially. This study evaluates the specialty-specific feasibility and financial impact of remote outpatient care using comprehensive administrative data from a large public training and research hospital in Izmir, supplemented by qualitative input from clinical specialists. The analysis includes 577,984 outpatient visits recorded in 2022 across major medical specialties. Eligibility for remote delivery is identified using observable clinical proxies-imaging requests, laboratory tests, and prescription issuance-to capture visits not requiring physical examination or procedural intervention. Results show that 121,248 visits (21.0%) are suitable for remote delivery, accounting for 16.2% of expenditures ($0.68 million out of $4.20 million). Remote eligibility varies substantially across specialties, with high suitability in dermatology and infectious diseases but limited applicability in device-dependent fields such as pulmonology. Four implementation scenarios are simulated over a 10-year horizon: Regulatory Compliance, Evidence-Based Specialty-Specific, Follow-Up Only, and Hybrid Progressive. The Regulatory Compliance scenario yields the shortest break-even period (3 years) and highest ROI (1185%). The Hybrid Progressive scenario, incorporating phased specialty expansion and AI-supported triage, requires higher upfront costs but generates the largest cumulative net savings ($1.39 million). The findings demonstrate that financially sustainable remote outpatient care can be achieved through carefully designed, specialty-specific implementation strategies.</p>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148621833","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":"Health System Resilience and Afghan Refugee Health in Pakistan: An Exploratory Study of Challenges and Pathways to Inclusion.","authors":"Zahid Ali Memon, Asma Ummad, Amina Olabi, Natasha Palmer, Sophie Witter","doi":"10.1002/hpm.70113","DOIUrl":"https://doi.org/10.1002/hpm.70113","url":null,"abstract":"<p><p>Pakistan has hosted Afghan refugees for more than four decades, in one of the world's most protracted displacements of people. Afghan refugees receive health services through United Nations High Commissioner for Refugees (UNHCR) and non-governmental organisation (NGO) supported programmes alongside public sector facilities at every tier. They remain excluded from key national health protection programmes such as the Sehat Sahulat Programme. Understanding the system-level enablers and barriers is essential for advancing equitable and sustainable healthcare for refugees and host populations. An exploratory qualitative case study was conducted using 30 key informant interviews and three participatory Group Model Building (GMB) workshops across Khyber Pakhtunkhwa, Sindh, and Islamabad Capital Territory. Data were thematically analysed using a Health System Resilience and Refugee Response Framework. Findings reveal a mixed picture of resilience and fragility. Refugees with Proof of Registration and Afghan Citizen Cards reported using primary care on a par with residents, while high reported immunisation coverage was widely perceived to have reduced polio risk among Afghan refugee children since around 2014, in line with national data showing a sharp decline in wild poliovirus cases over this period. While essential health services are being provided to refugees in the camps, they continue to face critical shortages, including frequent stock-outs of medicines, limited diagnostic capacity, too few trained female healthcare providers, and fragmented referral pathways. Financing remains heavily donor-dependent, with refugees excluded from the Sehat Sahulat Programme, the National Health Insurance programme. Governance challenges, including overlapping mandates, poor coordination, and a lack of refugee-specific data, undermine efficiency and planning. Despite these challenges, community health workers and shared health initiatives fostered social cohesion and equitable treatment in public sector health facilities. Our study demonstrates that inclusive health services can be delivered in Pakistan at scale but cannot be sustained and scaled without broader health system strengthening reforms. The inclusive and resilient refugee health services require embedding refugee health into national strategies, ensuring predictable financing, stronger coordination mechanisms, and integrating refugee data into health management information systems. These findings offer lessons for other host countries managing protracted refugee crises that create substantial challenges for national health-system financing, workforce, and service delivery.</p>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148608638","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":"Inclusion of Refugees Into National Health Systems: Enablers, Barriers and Lessons From Six Country Case Studies.","authors":"Sophie Witter, Alastair Ager, Karin Diaconu, Zahid Ali Memon, Ben Ngoye, Natasha Palmer, Marcia Vera-Espinoza, Amina Olabi, Hussam Rekani, Hassan Ould Moctar, Ricardo Chuquimia, Chitalu Miriam Chama-Chiliba, Ibrahim Bou-Orm, Maria Paola Bertone","doi":"10.1002/hpm.70109","DOIUrl":"https://doi.org/10.1002/hpm.70109","url":null,"abstract":"<p><p>The global refugee population has nearly doubled in the last decade, and many of these populations face chronic displacement, often in neighbouring countries with limited resources. Emergency, short-term responses are being transitioned to longer term approaches, including a focus on inclusion through coverage in national health systems. However, analysis of empirical and comparative evidence on how to enact these approaches has been limited. In this article, we analyse the inclusion of refugees in six low and middle-income country (LMIC) health systems (Kenya, Kurdistan Region of Iraq (KRI), Mauritania, Pakistan, Peru and Zambia). Using a shared framework and tools, we collected data over 2023 to 2025, using document reviews, key informant interviews, focus group discussions and participatory workshops. Analysis was carried out separately for each setting, validated locally, and later compared for synthesis. We focus on key health system domains-governance, health financing, service delivery (including the health workforce) and health information systems-outlining the attributes of refugee inclusion and system integration in each, identifying patterns across the case studies and barriers and enablers. We identify leverage points for improving integration but highlight that inclusion of refugees into national health systems is complex and does not guarantee improved outcomes, especially when refugees previously benefited from a higher level of resources and are being included in strained host health systems. However, committed government leadership, coordinated international support, and multi-year investments in strengthening key components of the local health system, including enabling refugee health staff to engage effectively in it, can make the transition to an integrated system a beneficial one for both refugee and host communities.</p>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148580714","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":"Return on Investment of HIV Care Within Universal Health Coverage in Low- and Middle-Income Countries: Evidence From Morocco","authors":"Chakib Boukhalfa,&nbsp;Ibtissam Khoudri,&nbsp;Nourredine Sakhri,&nbsp;Khadija Belbachir,&nbsp;Meriem Ghanam,&nbsp;Boutaina Selma EL Omari,&nbsp;Saad Zbiri,&nbsp;Mohammed Youbi","doi":"10.1002/hpm.70081","DOIUrl":"10.1002/hpm.70081","url":null,"abstract":"<div>\u0000 \u0000 <p>HIV is a serious disease requiring long-term care and incurring high economic costs, particularly in low- and middle-income countries (LMICs). In Morocco, since 1998, the Ministry of Health has provided free care for people living with HIV, with financial support from the Global Fund. The study assessed the return on investment of providing HIV care as part of universal health coverage (UHC) financed by national health insurance in order to reduce dependence on international aid. We measured the benefit-cost ratio of the direct benefits and expected economic costs of HIV care under UHC between 2022 and 2025. We considered the essential HIV care package, which includes antiretroviral treatment, other medicines for some opportunistic infections, initial HIV testing, follow-up immunovirological tests, and medical visits. The total cost of HIV care as part of UHC between 2022 and 2025 was estimated at 1,036,675,480 Moroccan Dirhams (MAD). The monetary value gained as a result of the 4136 deaths avoided was estimated at 3,732,997,634 MAD. The return on investment was therefore estimated at 3.6 ≈ 4. This return on investment could be even higher, considering the indirect and/or social benefits. The provision of care and treatment to people living with HIV as part of UHC appears to be an efficient strategy in Morocco. This finding may inform UHC efforts in other LMICs.</p>\u0000 </div>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":"41 4","pages":"683-691"},"PeriodicalIF":2.5,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147785596","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 Smart Elderly Care Technology Application on Social Isolation Among Urban Elderly Living Alone: Based on a Quasi-Natural Experiment in the Yangtze River Delta Urban Agglomeration From 2018 to 2023","authors":"Qianqian Hu,&nbsp;Heguang Wang","doi":"10.1002/hpm.70083","DOIUrl":"10.1002/hpm.70083","url":null,"abstract":"<div>\u0000 \u0000 <p>Amidst accelerated urbanisation and population ageing in China, urban solo-dwelling elders face escalating social isolation—manifested through diminished physical networks and profound psychological loneliness—severely compromising their well-being. To address gaps in existing studies (such as short-term evaluations and insufficient heterogeneity exploration), this research employs a quasi-natural experiment leveraging regional disparities in smart elderly care policy implementation within the Yangtze River Delta urban agglomeration. By constructing treatment and control groups through multi-level matching of individual behavioural data and city-level indicators across technology-advanced and technology-lagging regions, we assess the technology's sustained impact. Findings reveal that smart elderly care interventions significantly alleviate social isolation, yet effects exhibit pronounced regional stratification and age-based differentials. Elders residing in areas with strong infrastructure and policy enforcement, alongside younger cohorts (exemplified by the 65–75 age group), gain substantially greater benefits. The technology operates via dual mechanisms: intensifying community participation and optimising health self-management behaviours. Crucially, individual education attainment, family support networks, and regional resource allocation efficiency emerge as key moderators of impact magnitude. This study not only deciphers the dynamic process of technology-facilitated social capital accumulation but also warns that unevenly distributed technological dividends may deepen marginalisation of vulnerable subgroups (such as the oldest-old or low-literacy elders). These insights provide theoretical grounding for designing inclusive age-friendly technologies and formulating spatially calibrated health resource allocation policies in ageing societies.</p>\u0000 </div>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":"41 4","pages":"723-739"},"PeriodicalIF":2.5,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147943350","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":"International Assessment of Service Quality in Healthcare Organisations: A Systematic Review and Meta-Analysis","authors":"Yusuf Çelik,&nbsp;Ferdane Betül Bölükbaşı,&nbsp;Feyza Şenay Ulaş,&nbsp;Tuna Aybike Göktaş","doi":"10.1002/hpm.70084","DOIUrl":"10.1002/hpm.70084","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Objectives</h3>\u0000 \u0000 <p>The performance of healthcare organisations with their considerably complex structures is often on the agenda due to limited resources. Service quality, commonly assessed using the SERVQUAL scale, represents a key performance dimension in healthcare delivery. This paper aims to investigate the extent of meeting the expectations in health service provision in Turkiye and countries in Asia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We searched electronic databases, namely Web of Science, Google Scholar, PubMed, and Turkish Council of Higher Education National Thesis Centre, to find relevant and accessible English and Turkish studies published until 1 January 2023. Eligible studies were empirical research conducted in healthcare settings using the SERVQUAL scale and reporting expectation–perception gaps. Mean differences with 95% confidence intervals were calculated. Heterogeneity was assessed using the <i>I</i>² and <i>τ</i>² statistics, and publication bias was evaluated using funnel plots and Egger's test.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 47 studies (<i>N</i> = 13,581) were included. The highest quality gap occurred in the responsiveness (0.59) and reliability (0.54) dimensions. Patients had high levels of expectations from healthcare organisations in all five subdomains examined for both Turkiye and other Asian countries.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Highly significant quality gaps in the examined domains emphasise the need for improvements in appropriate and quality service delivery and the implementation of compassionate patient-centred approaches. We have concluded that healthcare managers and decision-makers should regularly monitor the quality level of provided healthcare services, find the gaps that need to be improved, and better understand how client expectations in healthcare might be shaped in different settings and countries. Limitations include the restriction to English and Turkish languages, the cross-sectional design of studies, and variability in hospital settings. No protocol was registered.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":"41 4","pages":"703-722"},"PeriodicalIF":2.5,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147869986","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":"Internationally Educated Nurse (IEN) Integration in Nova Scotia: A Provincial Realist Evaluation","authors":"Alyssa Indar,&nbsp;Meaghan Sim,&nbsp;Ruth Martin-Misener,&nbsp;Annette Elliott-Rose","doi":"10.1002/hpm.70080","DOIUrl":"10.1002/hpm.70080","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Canada is committed to supporting internationally educated nurse (IEN) integration into the healthcare system, as a strategy to address post-pandemic nursing shortages. The province of Nova Scotia has emerged as a Canadian exemplar with the development of NICHE (Nova Scotia's International Community of Healthcare Workers Engagement) programme, which anchors intersectoral collaboration between the government, the nursing regulator and healthcare systems in service of streamlining IEN integration.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a province-wide realist evaluation of the integration of IENs into the Nova Scotia healthcare system and community. We collected data from interviews with 24 participants, comprised of IENs and stakeholders at meso- and micro-healthcare system levels. We used a theory-driven approach to data analysis which utilised elements of content analysis, reflective dialogue and the construction of CMOCs (context-mechanism-outcome configurations).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We constructed three main CMOCs which highlight facilitators for IEN integration related to (1) the development of adaptive programme pathways for IENs, (2) the critical role of IEN allies and advocates within healthcare systems, and (3) the shift in focus from recruitment to retention.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The study findings describe the contextual factors and key mechanisms that promote ‘successful’ IEN integration which may be useful for leaders and policymakers integrating IENs into their local health human workforce. The findings raise important questions about supporting IEN retention, consistent with the vision for a healthy and sustainable nursing workforce. The findings from this study underscore the need for further evaluation research in on the topic of IENs.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":"41 4","pages":"692-702"},"PeriodicalIF":2.5,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hpm.70080","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147822094","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":"From Parallel Provision to Health System Integration: Exploring the Trajectory and Contextual Drivers of the Healthcare Response for Refugees in Six Low- and Middle-Income Countries","authors":"Maria Paola Bertone,&nbsp;Natasha Palmer,&nbsp;Amina Olabi,&nbsp;Ibrahim Bou-Orm,&nbsp;Hussam Rekani,&nbsp;Hassan Ould Moctar,&nbsp;Ricardo Chuquimia,&nbsp;Chitalu Miriam Chama-Chiliba,&nbsp;Ben Ngoye,&nbsp;Zahid Ali Memon,&nbsp;Marcia Vera-Espinoza,&nbsp;Karin Diaconu,&nbsp;Alastair Ager,&nbsp;Sophie Witter","doi":"10.1002/hpm.70071","DOIUrl":"10.1002/hpm.70071","url":null,"abstract":"<p>Rising numbers of refugees, prolonged displacement and reduced funding have led to challenges in terms of how to address their healthcare needs, with different approaches taken, ranging from parallel mechanisms to arrangements that are integrated (to different extents) within the national health system. Increasingly, global frameworks call for focus on the inclusion of refugees in national health systems. Based on six case studies (Kenya, Kurdistan Region of Iraq, Mauritania, Pakistan, Peru and Zambia), this paper analyses the trajectory towards health system integration in the healthcare responses for refugees to understand how contextual features play a role, and explores enablers and barriers of greater health system integration. Methods included documentary reviews, key informant interviews and focus group discussions (FGDs). Analysis was carried out separately for each setting and findings were later mapped, compared and contrasted for synthesis. All settings follow a normative pathway from an initial parallel response to hybrid, transitional arrangements to health system integration—though the latter is at different stages across settings. Some elements influence the timeframe of the shift, its completeness and effectiveness. These include: the scale and pace of refugee flow; the salience of political discourses on refugees and public perceptions, in some instances mediated by ethnic and cultural affinity; the country's level of income and social protection systems; existing legal and policy frameworks, refugee rights and societal integration processes; availability of funds; capacity of the national health system, and its universalist approach. While it is difficult to alter some of these elements, each has to be carefully considered for health system integration processes. Priorities will generally include promptly strengthening local health systems to address the difference in healthcare provision for refugees and hosts, and effectively leveraging available funding (including from development and private sector sources) as well as existing, inclusive health system arrangements, such as free healthcare or social health insurance.</p>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":"41 4","pages":"607-621"},"PeriodicalIF":2.5,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hpm.70071","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147619135","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":"Guiding Healthcare Organizations in Strategic Pathways: Assessing a Dynamic Adaptive Model","authors":"Anke Aarninkhof-Kamphuis,&nbsp;Hans Voordijk,&nbsp;Geert Dewulf","doi":"10.1002/hpm.70069","DOIUrl":"10.1002/hpm.70069","url":null,"abstract":"<p>In an era of increasing uncertainty and complexity, healthcare decision makers must navigate dynamic environments with greater awareness and adaptability. This study assesses what the impact is of the Dynamic Adaptive Decision Support model (DADS) on stewarding capacity by fostering adaptability, resilience, and strategic foresight. Using the concept of stewarding capacity, operationalised from the context of public policy to the context of organizations, the study assesses the extent to which DADS enables healthcare leaders to anticipate and deal with long-term uncertainties, risks, and changes. A longitudinal quasi-experimental study was conducted and embedded in an ongoing strategic management process, namely the strategic real estate plan, within a healthcare organization—a context strongly influenced by fluctuating demands and unpredictable external factors. The DADS intervention was applied through structured group and individual sessions, after which participants were interviewed using open-ended questions to evaluate its impact on stewarding capacity. Findings reveal that DADS significantly enhances stewarding capacity by facilitating a collaborative knowledge-generation process, strengthening self-organization across multiple levels, and fostering continuous monitoring and learning. However, the study also uncovers challenges, particularly in leveraging partnerships for knowledge-sharing and reinforcing self-organization through cross-sectoral networks. These insights suggest that while DADS holds promise as an innovative decision-support tool, its operationalisation requires further refinement. Ultimately, this study demonstrates that DADS has the potential to evolve into a transformative approach for strategic planning and management in healthcare. As organizations face an era of increasing complexity, integrating adaptive decision-making frameworks like DADS may prove essential in ensuring sustainable, forward-thinking strategies.</p>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":"41 4","pages":"559-571"},"PeriodicalIF":2.5,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hpm.70069","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147475261","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}