International Journal of Health Planning and Management最新文献

{"title":"Securing Global Health in the Face of Changing U.S. Policy: The Case for Strengthening National Public Health Institutes","authors":"Quentin Sandifer,&nbsp;Duncan Selbie,&nbsp;Sadaf Lynes,&nbsp;Neil Squires","doi":"10.1002/hpm.3925","DOIUrl":"10.1002/hpm.3925","url":null,"abstract":"<div>\u0000 \u0000 <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>\u0000 </div>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":"40 4","pages":"1015-1017"},"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,&nbsp;Chukwunonso Nwaokorie,&nbsp;Naanma Kangkum,&nbsp;Lola Ameyan,&nbsp;Obruche Sophia Ogefere,&nbsp;Eric Aigbogun,&nbsp;Valentine Amasiatu,&nbsp;Uchenna Igbokwe","doi":"10.1002/hpm.3910","DOIUrl":"10.1002/hpm.3910","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The quality of oxytocin and misoprostol, the most widely used uterotonics for postpartum haemorrhage (PPH) management, suffer supply chain challenges and climactic susceptibilities.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To describe a supply chain strengthening programme for introducing heat-stable Carbetocin (HSC), to health facilities in Kano, Lagos and Niger states.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>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>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>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>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>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>\u0000 </section>\u0000 </div>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":"40 3","pages":"701-715"},"PeriodicalIF":1.9,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hpm.3910","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Counting Midwives Providing Clinical Care in Nevada","authors":"Jennifer Vanderlaan,&nbsp;Janice Enriquez,&nbsp;Melva Thompson-Robinson","doi":"10.1002/hpm.3921","DOIUrl":"10.1002/hpm.3921","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To estimate the number of midwives providing care primarily in Nevada.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Study Setting and Design</h3>\u0000 \u0000 <p>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>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Data Sources and Analytic Sample</h3>\u0000 \u0000 <p>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 &amp; Provider Enumeration System Data Dissemination file enumerates identified as advanced practice midwives with a Nevada licence or practice location in Nevada.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Principle Findings</h3>\u0000 \u0000 <p>Only 55% of nurse-midwives with active Nevada licences are providing care full-time in Nevada.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>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>\u0000 </section>\u0000 </div>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":"40 4","pages":"1002-1006"},"PeriodicalIF":1.9,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hpm.3921","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":"OA","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,&nbsp;Colin G. Knox","doi":"10.1002/hpm.3920","DOIUrl":"10.1002/hpm.3920","url":null,"abstract":"<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 <i>in</i> each of the two years and then examining whether the propensity to LTLI changed <i>between</i> 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 <i>higher</i> 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 <i>lower</i> 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 <i>higher</i> 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":"40 4","pages":"849-862"},"PeriodicalIF":1.9,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hpm.3920","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":"OA","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,&nbsp;Milena Vainieri,&nbsp;Sabina De Rosis","doi":"10.1002/hpm.3912","DOIUrl":"10.1002/hpm.3912","url":null,"abstract":"<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":"40 3","pages":"688-700"},"PeriodicalIF":1.9,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hpm.3912","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":"OA","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,&nbsp;Gal Av-Gay,&nbsp;Tom Skinner,&nbsp;Jude Kornelsen","doi":"10.1002/hpm.3898","DOIUrl":"10.1002/hpm.3898","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>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>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>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>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>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>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>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>\u0000 </section>\u0000 </div>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":"40 3","pages":"672-687"},"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}

{"title":"Editorial: Patient Experience Data and Feedback for Quality Improvement and Learning Health Systems","authors":"Tiago S. Jesus,&nbsp;Gagan Gurung,&nbsp;Catherine Quatman-Yates","doi":"10.1002/hpm.3917","DOIUrl":"10.1002/hpm.3917","url":null,"abstract":"&lt;p&gt;Patients, families, and their representative groups must be key active participants (i.e. co-designers or co-producers) of healthcare and its improvement [&lt;span&gt;1-6&lt;/span&gt;]. As one way to achieve this, healthcare systems and services need mechanisms to capture, process, and translate user feedback — including patient experience data — into healthcare improvement activities [&lt;span&gt;3, 7-11&lt;/span&gt;]. User feedback — either quantitative or qualitative — can be gathered through routinely available data such as patient experience surveys, complaints, and online comments, or actively solicited by providers through bedside rounding, patient narratives, and photovoice initiatives, among others [&lt;span&gt;5, 12-16&lt;/span&gt;]. Patient experience and user feedback can serve various purposes, from consultative roles (e.g., patient and family advisory councils), service evaluation purposes (e.g., experience surveys) and as part of collaborative co-design approaches - wherein patients, families or their representative become key partners for new service delivery approaches [&lt;span&gt;11, 17, 18&lt;/span&gt;]. Therefore, effectively leveraging user feedback can drive quality improvement (QI) activities, transformative service redesigns, and the creation and evaluation of new healthcare services, programs, or policies. Additionally, user feedback and input may also be integrated into Learning Health Systems (LHS) to support user-centred practice improvement that also drives knowledge generation and sharing [&lt;span&gt;19, 20&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;To realise these outcomes, user feedback must be systematically collected, processed, analysed, and relayed in a timely manner to providers, enabling real time application at the point of care [&lt;span&gt;12&lt;/span&gt;]. This often necessitates the development, study, and implementation of systems and processes that ensure user feedback is intentionally and meaningfully utilised to enhance healthcare and its person-centeredness.&lt;/p&gt;&lt;p&gt;In early 2024, we issued a ‘call for papers’ for a special issue on ‘Patient Experience Data and Feedback for Quality Improvement and Learning Health Systems’, for the &lt;i&gt;International Journal of Health Planning and Management&lt;/i&gt;. During the first phase of the two-step submission process, we received 159 abstracts from authors across five continents, including from low- and middle-income countries (LMIC). Following an initial screening based on scope, methodological quality, and diversity, a little over 10% of the abstracts were invited for a full-text submission for peer review. From the pool of submitted papers, 13 were finally accepted for publication.&lt;/p&gt;&lt;p&gt;Among the articles included, one focuses on a low-income nation (Democratic Republic of Congo), three examine middle-income countries (Argentina, China, and Peru), and two analyse multi-country data that includes nations with varying income levels. Seven papers addressed high-income countries, with three from the USA and one each from Australia, Canada, Italy, and Swe","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":"40 4","pages":"797-801"},"PeriodicalIF":1.9,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hpm.3917","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494179","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":"Implementation of Automated PREM Process to Better Capture Patients' Overall Experience of Care Services at Karolinska University Hospital","authors":"Alexandre Chakhunashvili,&nbsp;Anna Blommengren,&nbsp;Anna Kullberg","doi":"10.1002/hpm.3918","DOIUrl":"10.1002/hpm.3918","url":null,"abstract":"<div>\u0000 \u0000 <p>To improve healthcare quality there has been a growing interest in collecting and analysing patient feedback. Patient Reported Experience Measures (PREMs) are instruments through which the feedback can be collected and used for improvement purposes. However, the collection process is often associated with an administrative burden for healthcare professionals who collect and register surveys manually. Additionally, the manual procedure limits the data collection efforts to fewer patients, thus resulting in a less representative sample. A digital and automated procedure for collecting and visualising patient experience data can relieve healthcare staff and allow more patients to share their experiences. At Karolinska University Hospital, a multi-disciplinary project to develop the automated PREM process—from data collection to visualisation—has been undertaken. As a result, there are about 25,000 digital questionnaires distributed per month with the response rate of approximately 35%–40%. This is an equivalent of about 9000 completed questionnaires per month to be compared to less than 1000 responses per month received during the manual process used before 2021. The large amount of patient experience data is analysed and made accessible to the hospital management and staff. To increase the transparency, part of the collected data is visualised at Karolinska's external website. Furthermore, hospital staff is relieved from all survey administration. Remaining challenges concern survey language and the analysis of textual responses that are not yet done at hospital level. Overall, this initiative has led to several quality improvement activities and contributed to strengthening Karolinska's internal learning health system.</p>\u0000 </div>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":"40 4","pages":"838-848"},"PeriodicalIF":1.9,"publicationDate":"2025-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143484367","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":"Professionalisation of Community Health Workers: Formalisation as a Second Pillar of Job Security","authors":"Roosa Sofia Tikkanen","doi":"10.1002/hpm.3913","DOIUrl":"10.1002/hpm.3913","url":null,"abstract":"","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":"40 4","pages":"1013-1014"},"PeriodicalIF":1.9,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143477146","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":"Regional Inequalities in the Allocation of Specialist Doctors Within the Portuguese NHS","authors":"William de Melo,&nbsp;Ana Sofia Ferreira","doi":"10.1002/hpm.3914","DOIUrl":"10.1002/hpm.3914","url":null,"abstract":"<div>\u0000 \u0000 <p>This paper addresses regional disparities in the allocation of medical professionals within the Portuguese National Health Service (NHS) and its policy implications, drawing recommendations to address these inequalities. In a country with a universal and comprehensive healthcare system, ensuring equitable geographical distribution of healthcare professionals is crucial for the effectiveness and equity of the health system. The analysis uses data from the NHS payroll system (RHV), covering the period from 2017 to 2023, and focuses on active medical workers, including those on duty and retired but still in service, distributed among the five Regional Health Administrations that then existed. The analysis is based on Full-Time Equivalents to provide a more realistic picture of the healthcare workforce. Population data comes from the official source. The Dissimilarity Index is used to measure regional disparities, focusing on the medical workforce (specialist doctors). The study aims to identify disparities in the distribution of these healthcare professionals throughout the five regions within the NHS and inform evidence-based policies to address such inequalities in resource allocation of the healthcare workforce. The findings reveal that while the overall density of NHS healthcare workers per 1000 inhabitants grew, and global disparities in the allocation of NHS workers slightly diminished, some regional disparities have worsened, as it was the case of the distribution of specialist doctors among the territory. The Dissimilarity Index indicates increasing inequality among the allocation of the medical workforce in the national territory, with statistically significant growth in disparity over time. The study underscores the urgent need for targeted policies to address these growing inequalities in allocating specialist doctors within the NHS.</p>\u0000 </div>","PeriodicalId":47637,"journal":{"name":"International Journal of Health Planning and Management","volume":"40 4","pages":"825-837"},"PeriodicalIF":1.9,"publicationDate":"2025-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143434105","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}