Health Care Management Review最新文献

{"title":"Profession-led vs collaborative workforce models in dental, vision, and hearing care for older adults in community care: A mixed-methods systematic review.","authors":"Hurjehan Kadernani, Svetlana Bogomolova, Jyoti Khadka, Rong Zhu, Giriraj S Shekhawat, Christopher Harrison, Madhan Balasubramanian","doi":"10.1097/HMR.0000000000000493","DOIUrl":"10.1097/HMR.0000000000000493","url":null,"abstract":"<p><strong>Background: </strong>Dental, vision, and hearing impairments are among the most prevalent long-term conditions affecting older adults, contributing to late-life disability and reducing quality of life. Early detection and prevention may reduce avoidable emergency hospitalizations and health system costs while enhancing well-being. Despite this, integrated service delivery across these sensory and oral health domains remains limited, especially in community care settings.</p><p><strong>Aim: </strong>This systematic review aimed to synthesize evidence on integrated workforce models involving dental, vision, and hearing professionals within community care settings for older adults.</p><p><strong>Methods: </strong>A mixed-method systematic review was conducted using a comprehensive three-step search strategy across MEDLINE, CINAHL, Web of Science, Embase, and Scopus spanning January 2010 to December 2024, and updated in October 2025. In all, 798 articles were identified, with 14 meeting inclusion criteria for convergent integrated synthesis. Included studies involved adults aged 60+ or with samples containing at least 50% older adults, examining community-based models where dental, vision, or hearing personnel collaborated with at least one other health or welfare provider. Critical appraisal and data synthesis followed the Joanna Briggs Institute methodology.</p><p><strong>Results: </strong>Of the 14 studies (5 qualitative, 6 mixed methods, 3 quantitative), 9 focused on dental, 3 on vision, and 2 on hearing workforce models. Studies were primarily from the United States (n=8), Australia (n=2), the Netherlands (n=2), Germany (n=1), and Norway (n=1). Two workforce model types emerged inductively: profession-led models (n=10), characterized by leadership and care coordination, and led by a dental, vision or hearing expert, and collaborative-led models (n=4), featuring shared leadership and an extended skill mix. Profession-led models emphasized clinical interventions; collaborative-led models prioritized health promotion and prevention. Reported outcomes primarily related to service delivery, workforce processes, and patient experiences, including patient satisfaction. Evidence of clinical effectiveness outcomes was limited, and studies varied substantially in design, context and outcome measures.</p><p><strong>Conclusion: </strong>Integrated workforce models in dental, vision, and hearing for older adults in community care show promise in improving care delivery processes and patient-reported outcomes. However, the current evidence base is limited and heterogenous, with few robust evaluations of clinical effectiveness. As such, these models need to undergo further rigorous research to assess their effectiveness, scalability, and context-specific implementation.</p>","PeriodicalId":47778,"journal":{"name":"Health Care Management Review","volume":"51 3S","pages":"S86-S95"},"PeriodicalIF":2.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148363025","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of the physician-pharmacist partnership intervention to deprescribe medications (P3iD) and its feasibility in clinical practice.","authors":"Sheron Sir Loon Goh, Siti Nurkamilla Ramdzan, Kit Mun Tan, Maw Pin Tan, Pauline Siew Mei Lai","doi":"10.1097/HMR.0000000000000482","DOIUrl":"10.1097/HMR.0000000000000482","url":null,"abstract":"<p><strong>Background: </strong>Polypharmacy and the use of potentially inappropriate medications (PIMs) are major concerns in managing older adults with multiple chronic conditions, as they can increase the risk of adverse drug reactions. However, data on deprescribing interventions for older persons in lower- to middle-income countries (LMIC) remains limited.</p><p><strong>Purpose: </strong>To develop and evaluate the feasibility of the Physician-Pharmacist Partnership Intervention to Deprescribe Medications (P3iD) among ambulatory older persons.</p><p><strong>Methodology/approach: </strong>The P3iD, a health workforce model intervention for deprescribing medications among older adults, was developed based on findings from previous literature and a qualitative study. This intervention consists of five steps: (1) potentially inappropriate medication (PIM) identification, (2) decisions on prioritization of cessation, (3) medication withdrawal, (4) monitoring and support, and (5) documentation. A feasibility study was conducted in March 2022 at a tertiary primary care clinic at a teaching hospital, which offers general outpatient services, including preventive care, routine health check-ups, and chronic disease management. Participants aged 65 years or older with multiple chronic diseases, prescribed five or more medications with at least one PIM (according to Beer's Criteria 2019), were recruited. Physician partners were drawn from their treating physicians, who comprised family medicine trainees. The intervention was conducted by a pharmacist in collaboration with the patient's doctor.</p><p><strong>Results: </strong>Twenty participants and 14 doctors were recruited. Participants consumed a total of 167 medications, from which 36 (22%) PIMs were identified. Deprescribing was performed on 14/20 (70%) older patients. The number of PIMs accepted for deprescribing was 19/36 (52.7%).</p><p><strong>Conclusion and practice implications: </strong>Recruiting older adult participants and conducting the P3iD in a tertiary primary care clinic was feasible. Incorporating deprescribing into routine practice through periodic medication reviews provides a structured, safer, and more effective approach to managing polypharmacy and improving patient outcomes, subsequently optimizing health management and strengthening health care systems.</p>","PeriodicalId":47778,"journal":{"name":"Health Care Management Review","volume":" ","pages":"S5-S13"},"PeriodicalIF":2.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148340565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term care policies in the Asia-Pacific Aged Care Hub (APACH) countries: A scoping review.","authors":"Teddy Andrews Jaihind Jothikaran, Abhijith A Kumar, Ivan Neil Gomez, Kejal Hasmukharay, Lakshmi Balraj, Maw Pin Tan, Akhmad Azmiardi, Farahdilla Mirshanti, Divya Susanna Patil","doi":"10.1097/HMR.0000000000000488","DOIUrl":"10.1097/HMR.0000000000000488","url":null,"abstract":"<p><strong>Background: </strong>With the rapid agiing of populations globally, the demand for long-term care (LTC) services for older people is growing exponentially. However, policy responses across the region have varied significantly. Purpose: This scoping review aims to map and describe available policies that address LTC within the Asia-Pacific Aged Care Hub (APACH) countries, specifically examining governance, implementation, and strategic challenges in this area.</p><p><strong>Methodology/approach: </strong>This scoping review followed the framework as outlined by Arksey and O'Malley (2005). A comprehensive literature search was conducted on five electronic databases, including PubMed, Scopus, CINAHL, and Web of Science. Grey literature was identified through Google Scholar, government and public health websites. A two-stage screening process was undertaken by two reviewers independently, which was followed by data extraction and synthesis.</p><p><strong>Findings: </strong>We identified 310 articles, of which 85 were included for full review. The studies revealed that there are health policies in place in all the APACH countries. The two prevalent LTC models are residential care and community-based care. The policy documents have a common focus on LTC for older adults with emphasis on infrastructure, governance and funding, and capacity building. Effective operationalization of the existing policies has been challenged by current structural and capacity issues. Although the aged care policies have included monitoring and evaluation frameworks, comprehensive assessments of policy impact remain limited.</p><p><strong>Conclusions: </strong>Though there are policies for LTC, the review highlights significant gaps in the implementation of these policies across the APACH countries. There is a pressing need for robust regulatory frameworks and interagency collaboration to provide sustainable LTC approaches.</p><p><strong>Practical implications: </strong>Although APACH countries have adopted several approaches to LTC, it is critical to strengthen policies and initiatives regarding regulatory frameworks, health and social care integration, quality standards, and cultural adaptability to improve LTC administration and management.</p>","PeriodicalId":47778,"journal":{"name":"Health Care Management Review","volume":"51 3S","pages":"S68-S76"},"PeriodicalIF":2.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148363085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient-centric care technology configurations: An exploratory analysis of patient engagement systems, telehealth, and remote patient monitoring in U.S. hospitals.","authors":"Jung Young Lee, C Christopher Lee, Jeong Hoon Choi","doi":"10.1097/HMR.0000000000000491","DOIUrl":"10.1097/HMR.0000000000000491","url":null,"abstract":"<p><strong>Background: </strong>Despite the growing demand for patient-centered care (PCC), there is a limited understanding of how hospitals configure and coordinate patient-facing technologies, such as Patient Engagement Systems (PES), telehealth, and Remote Patient Monitoring (RPM), on a national scale.</p><p><strong>Purpose: </strong>This study seeks to identify existing technology configurations in U.S. hospitals and analyze the association between these configurations and various hospital performance measures.</p><p><strong>Methodology/approach: </strong>Using cluster analysis on data from over 3,300 U.S. hospitals, we developed a taxonomy of three distinct technology configurations: Patient-Centric Pioneers, Selective Tech Adopters, and Traditional Care Providers. The differences in structural characteristics and performance measures among these groups are statistically analyzed.</p><p><strong>Results: </strong>Hospitals in the Patient-Centric Pioneers group, which fully implement and effectively integrate PES, telehealth, and RPM, consistently outperform the others in terms of efficiency, clinical quality, and patient satisfaction. Selective Tech Adopters displayed the highest manpower productivity. However, they did not achieve better patient satisfaction than Traditional Care Providers with limited technologies.</p><p><strong>Practice implications: </strong>Our research presents a comprehensive, robust empirical taxonomy of PCC technology configuration and technology complementarity literature, highlighting a strong correlation between a holistic technology strategy and improved hospital-level performance. These findings encourage hospital administrators and policymakers to support the strategic and integrated implementation of PES, telehealth, and RPM, even after the COVID-19 pandemic has passed.</p>","PeriodicalId":47778,"journal":{"name":"Health Care Management Review","volume":" ","pages":"263-270"},"PeriodicalIF":2.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147785567","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Organizing under constraint: Paradox navigation in public health systems.","authors":"Soniya Rijal","doi":"10.1097/HMR.0000000000000479","DOIUrl":"10.1097/HMR.0000000000000479","url":null,"abstract":"<p><strong>Issue: </strong>Public health systems aim to deliver care that is effective, inclusive, efficient, and culturally responsive. However, they operate under persistent constraints such as limited funding, staff shortages, and aging infrastructure that generate enduring paradoxical tensions that frontline and middle-level actors continuously navigate to keep the health system functioning.</p><p><strong>Critical theoretical analysis: </strong>While existing research acknowledges that paradoxical tensions are persistent and experienced across organizational levels-from top-level managers to frontline health care workers, the theory on how they are managed beyond senior leadership remains thin. I introduce and theorize the concept of composite arrangements. This conceptchallenges the assumption that the health care system remains functional only through structural reform and explains how low-discretion actors in the public health system sustain continuity , adaptability , and legitimacy .</p><p><strong>Insight/advance: </strong>I advance understanding of paradox management in health care by shifting the focus from a leader-centered perspective to a distributed, ongoing process embedded in the everyday practices of actors with limited discretion. By introducing the concept of composite arrangements, I show how those with limited discretion to shape structure or policy can maintain the effectiveness of public health systems despite ongoing paradoxical tensions.</p><p><strong>Practice implications: </strong>I outline practical ways to address paradoxical tensions through composite arrangements when actors have limited discretion. In addition, I explain how public health organizations can strengthen these arrangements by fostering organizational cultures that embrace paradox amid resource scarcity to sustain the health system's functioning.</p>","PeriodicalId":47778,"journal":{"name":"Health Care Management Review","volume":" ","pages":"206-216"},"PeriodicalIF":2.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147582666","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The transdisciplinary imperative: Health and aged care management in an era of compounding challenge.","authors":"Madhan Balasubramanian, Amrita Kansal, Giriraj S Shekhawat, Noran N Hairi, Andreas Cebulla","doi":"10.1097/HMR.0000000000000495","DOIUrl":"10.1097/HMR.0000000000000495","url":null,"abstract":"<p><p>Health and aged care systems are increasingly confronted by ageing-related challenges that exceed the boundaries of any single discipline, profession, sector, or policy domain. This commentary proposes a transdisciplinary framework for health and aged care management as a shift from parallel domain-specific reforms to the deliberate design of structurally interconnected systems. We argue that workforce design, models of care, technology, governance, financing, and place-based environments must be understood as mutually constitutive elements of healthy ageing systems rather than discrete areas of improvement. The papers included in this special issue illustrate this systems-oriented framework across diverse contexts, including Saudi Arabia, Thailand, India, Finland, Malaysia, the Asia-Pacific region, and community care settings in high-income countries. Collectively, they demonstrate that reforms are more effective when governance arrangements align workforce capability, digital infrastructure, financing mechanisms, referral pathways, community legitimacy, and accountability structures. Conversely, siloed reform can exacerbate inequities, particularly in low- middle-income countries where fragmented systems divert scarce resources and shift hidden costs to families and communities. We argue that future research in health and aged care management should move beyond evaluating standalone innovations towards examining the \"connective tissue\" of reform: how integration is designed, governed, financed, implemented, measured, scaled, and sustained across systems. Transdisciplinary integration should therefore be understood not as a rhetorical aspiration, but as a practical governance discipline for ageing societies.</p>","PeriodicalId":47778,"journal":{"name":"Health Care Management Review","volume":"51 3S","pages":"S1-S4"},"PeriodicalIF":2.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148363165","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diversity and performance in health care: A systematic review of the evidence base.","authors":"Davide Trinchese, Manuela Furlan, Milena Vainieri, Gianluca Veronesi","doi":"10.1097/HMR.0000000000000478","DOIUrl":"10.1097/HMR.0000000000000478","url":null,"abstract":"<p><strong>Background: </strong>Diversity in the health care sector has been put forward as a key factor for improving organizational performance; however, the evidence based on this assumed positive impact is still fragmented.</p><p><strong>Purpose: </strong>Adopting a narrative and critical approach, this systematic review investigated the relationship between surface and deep-level diversity and performance in the health care sector. Performance is categorized into two main dimensions: relational performance, arising from interactions between groups of individuals within organizations, and organizational performance, which refers to outcomes related to the overall organizational activity.</p><p><strong>Methodology/approach: </strong>This systematic review focused on scientific papers published in English in international peer-reviewed journals, retrieved from the ISI Web of Science citation and search database. In addition, citation snowballing was employed to identify further relevant studies. A total of 58 papers were identified as meeting the research criteria.</p><p><strong>Findings: </strong>The analysis of the 58 selected studies indicates that at the organizational level, diversity has a generally positive effect on performance. At the team level, however, diversity is frequently linked with mixed or negative relational performance outcomes. Undesired consequences of diversity specifically relate to the emergence of homogeneous subgroups, so-called faultlines, in groups of individuals, ultimately leading to a negative impact on relational and organizational performance. At the board level, where the extant literature has mainly focused on gender diversity, increasing female representation appears to yield positive effects, except when it is already comparatively high.</p><p><strong>Practice implications: </strong>Policymakers and practitioners should recognize both the benefits and challenges of diversity in health care. While diversity is essential in such a complex sector, it may produce unintended negative consequences, particularly when diversity is at high levels or faultlines emerge. This highlights the importance of effective management strategies and human resource policies to optimize its impact.</p>","PeriodicalId":47778,"journal":{"name":"Health Care Management Review","volume":" ","pages":"190-205"},"PeriodicalIF":2.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13193181/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147311320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Leveraging AI-enabled learning health systems to advance value-based health care: A conceptual framework.","authors":"Dong-Gil Ko, Umberto Tachinardi, Eric J Warm, Brett M Kissela","doi":"10.1097/HMR.0000000000000472","DOIUrl":"10.1097/HMR.0000000000000472","url":null,"abstract":"<p><strong>Issue: </strong>Despite rapid innovation, health care systems face a persistent 17-year gap between evidence discovery and implementation, undermining efforts to deliver value-based care. Bridging this \"know-do gap\" is essential to improving outcomes and reducing waste. Existing Learning Health System (LHS) frameworks often lack mechanisms to institutionalize learning at speed and scale.</p><p><strong>Critical theoretical analysis: </strong>We propose an AI-enabled LHS framework that leverages artificial intelligence (AI) to connect micro-level clinical learning with macro-level organizational decision-making. Grounded in organizational learning theory, our model illustrates how AI accelerates knowledge capture, conversion, and institutionalization via continuous, bidirectional feedback loops. AI enables real-time learning cycles, linking patient-provider data (\"micro\") to system-wide insights and policy adjustments (\"macro\"), and back to point-of-care decision support.</p><p><strong>Insight/advance: </strong>Our framework advances the LHS paradigm by adding speed, scale, and micro↔macro integration. Unlike earlier models, it centers AI not as an adjunct but as a foundational learning engine. Case examples from UCHealth and Mass General Brigham show how AI can drive real-time operational learning and institutional memory through structured governance and data infrastructure.</p><p><strong>Practice implications: </strong>To implement an AI-LHS, organizations should (1) assess readiness and align on value-based goals; (2) invest in data infrastructure and interoperability; (3) cultivate a learning culture by engaging clinicians and staff; (4) embed AI into continuous improvement cycles with interdisciplinary governance; (5) adopt a sociotechnical approach integrating people, processes, and technology; and (6) ensure safeguards for equity, privacy, and security. These steps allow systems to reduce lag between insight and impact, accelerating value-based care transformation.</p>","PeriodicalId":47778,"journal":{"name":"Health Care Management Review","volume":" ","pages":"151-161"},"PeriodicalIF":2.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146144066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding clinician deviance: A systematic review of text messaging practices.","authors":"Michele L Heath, Tracy H Porter, Ashleigh Allgood","doi":"10.1097/HMR.0000000000000466","DOIUrl":"10.1097/HMR.0000000000000466","url":null,"abstract":"<p><strong>Background: </strong>Clinicians in the United States often prefer quick, efficient, and convenient ways to communicate with colleagues. However, using standard text messaging without a secure text messaging system (STMS) constitutes a violation of Health Insurance Portability and Accountability Act regulations.</p><p><strong>Purposes: </strong>This systematic review aims to investigate why clinicians might choose not to use STMSs when sharing patient health information (PHI) with their peers. This research will explore whether these clinicians are consciously disregarding federal guidelines concerning the texting of PHI and the reasons behind this choice. Deliberate noncompliance could be classified as a form of deviant behavior within the workplace.</p><p><strong>Methodology/approach: </strong>We conducted a Preferred Reporting Items for Systematic Review and Meta-Analysis-guided systematic literature review across four databases, examining 10 empirical studies from the United States published in English between January 2017 and August 2024.</p><p><strong>Conclusion: </strong>We identified deviant behaviors associated with the unsecured text messaging of PHI through a deductive approach. These behaviors were classified based on Lawrence and Robinson's workplace deviance framework, which includes the need for autonomy, social identity, and perceived organizational justice. We also found inductive themes, which included training needs and increased workloads.</p><p><strong>Practice implications: </strong>The findings of this study demonstrate a number of areas hospital leaders might examine relevant to this topic, including reluctance to use STMSs, a choice to adopt it, or a tendency to blame issues on inadequate policies or insufficient training. This situation emphasizes the necessity of offering comprehensive training and clear policies to address both the psychological barriers and practical challenges faced by clinicians.</p>","PeriodicalId":47778,"journal":{"name":"Health Care Management Review","volume":" ","pages":"78-86"},"PeriodicalIF":2.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146151079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recent trends in health care provider well-being research.","authors":"","doi":"10.1097/HMR.0000000000000473","DOIUrl":"10.1097/HMR.0000000000000473","url":null,"abstract":"","PeriodicalId":47778,"journal":{"name":"Health Care Management Review","volume":" ","pages":"67"},"PeriodicalIF":2.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146114511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}