Health Care Management Review最新文献

{"title":"Employee silence in health care: Charting new avenues for leadership and management.","authors":"Anthony Montgomery,&nbsp;Olga Lainidi,&nbsp;Judith Johnson,&nbsp;Jennifer Creese,&nbsp;Fredrik Baathe,&nbsp;Adriana Baban,&nbsp;Anindo Bhattacharjee,&nbsp;Madeline Carter,&nbsp;Lotta Dellve,&nbsp;Eva Doherty,&nbsp;Mimmi Kheddache Jendeby,&nbsp;Karen Morgan,&nbsp;Manjari Srivastava,&nbsp;Neill Thompson,&nbsp;Reidar Tyssen,&nbsp;Veena Vohra","doi":"10.1097/HMR.0000000000000349","DOIUrl":"https://doi.org/10.1097/HMR.0000000000000349","url":null,"abstract":"<p><strong>Issue: </strong>Health care management is faced with a basic conundrum about organizational behavior; why do professionals who are highly dedicated to their work choose to remain silent on critical issues that they recognize as being professionally and organizationally significant? Speaking-up interventions in health care achieve disappointing outcomes because of a professional and organizational culture that is not supportive.</p><p><strong>Critical theoretical analysis: </strong>Our understanding of the different types of employee silence is in its infancy, and more ethnographic and qualitative work is needed to reveal the complex nature of silence in health care. We use the sensemaking theory to elucidate how the difficulties to overcoming silence in health care are interwoven in health care culture.</p><p><strong>Insight/advance: </strong>The relationship between withholding information and patient safety is complex, highlighting the need for differentiated conceptualizations of silence in health care. We present three Critical Challenge points to advance our understanding of silence and its roots by (1) challenging the predominance of psychological safety, (2) explaining how we operationalize sensemaking, and (3) transforming the role of clinical leaders as sensemakers who can recognize and reshape employee silence. These challenges also point to how employee silence can also result in a form of dysfunctional professionalism that supports maladaptive health care structures in practice.</p><p><strong>Practice implications: </strong>Delineating the contextual factors that prompt employee silence and encourage speaking up among health care workers is crucial to addressing this issue in health care organizations. For clinical leaders, the challenge is to valorize behaviors that enhance adaptive and deep psychological safety among teams and within professions while modeling the sharing of information that leads to improvements in patient safety and quality of care.</p>","PeriodicalId":47778,"journal":{"name":"Health Care Management Review","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10728676","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":"Managing community engagement initiatives in health and social care: lessons learned from Italy and the United Kingdom.","authors":"Francesco Longo, Sara Barsanti, Manila Bonciani, Anita Bunea, Angelica Zazzera","doi":"10.1097/HMR.0000000000000343","DOIUrl":"10.1097/HMR.0000000000000343","url":null,"abstract":"<p><strong>Background: </strong>Determining the different features and potential impacts of community initiatives aimed at health-related outcomes poses challenges for both researchers and policy makers.</p><p><strong>Purpose: </strong>This article explores the nature of heterogeneous \"community engagement initiatives\" (CEIs) considering both their social and organizational features in order to understand the managerial and policy implications to maximize their potential local health and social care-related impacts.</p><p><strong>Methodology: </strong>A threefold qualitative analysis was conducted: (a) Three frameworks were developed to classify and analyze different CEIs features, building upon the current literature debate; (b) primary data were collected from Italian CEIs; and (c) a comparative cross-case analysis of a total of 79 CEIs in Italy and the United Kingdom was implemented.</p><p><strong>Findings: </strong>The results show two types of strategic policy and management implications: (a) CEI portfolios are very broad and differentiated; (b) different social networks have diversified social constructs, internal cultures, and organizational features; and (c) there is a consequent need to contextualize relational and steering approaches in order to maximize their potential community added value.</p><p><strong>Conclusion: </strong>CEIs are fundamental pillars of contemporary welfare systems because of both the changing demography and epidemiology and the disruptive impact of platform economy models. This challenging scenario and the related CEIs involve a complex social mechanism, which requires a new awareness and strengthened competences for public administrations' steering.</p><p><strong>Practice implications: </strong>It is crucial for policy makers and managers to become familiar with all the different CEIs available in order to choose which solution to implement, depending on their potential impacts related to local public health and social care priorities. They also need to select the related effective steering logic.</p>","PeriodicalId":47778,"journal":{"name":"Health Care Management Review","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/10/51/hcmr-48-02.PMC9704808.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10735623","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":"Relationships and resilience at work and at home: Impact of relational coordination on clinician work-life balance and well-being in times of crisis.","authors":"Hebatallah Naim Ali,&nbsp;Jody Hoffer Gittell,&nbsp;Sien Deng,&nbsp;Cheryl D Stults,&nbsp;Meghan Martinez,&nbsp;Suzanne Pertsch,&nbsp;Lauren Weger,&nbsp;Ellis C Dillon","doi":"10.1097/HMR.0000000000000355","DOIUrl":"https://doi.org/10.1097/HMR.0000000000000355","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic has been an unusually comprehensive crisis that has taken a toll on people in their roles both at work and at home, giving rise to a new normal.</p><p><strong>Purpose: </strong>Relational coordination theory shows how communicating and relating for the purpose of task integration drives positive outcomes for workers, their clients, and their employers. The ecological theory of work-family spillover shows how relational dynamics from work spillover into family life, and vice versa. We build upon these two theories to understand how relationships at work impact work-life balance and worker well-being, especially in times of crisis.</p><p><strong>Methodology: </strong>This study was based on surveys of clinicians affiliated with a large California health system during the COVID-19 pandemic. Mediation and multilevel logistic regression models were used to assess how relational coordination among colleagues impacts well-being (job satisfaction and lack of burnout) through its effects on work-life balance (schedule control and personal time).</p><p><strong>Results: </strong>A 1-point increase in relational coordination tripled clinician odds of having schedule control ( OR = 3.33, p < .001) and nearly doubled the odds of having adequate personal time ( OR = 1.83, p < .001). A 1-point increase in relational coordination nearly quadrupled odds of being satisfied with their job ( OR = 3.92, p < .001) and decreased odds of burnout by 64% ( OR = 0.36, p < .001). The impact of relational coordination on worker well-being was mediated by greater schedule control and personal time.</p><p><strong>Conclusion: </strong>Relational coordination among colleagues impacts worker well-being by enabling greater control over one's schedule and more personal time, thus creating a positive spillover from work to home in times of crisis.</p><p><strong>Practice implications: </strong>In times of crisis, leaders should prioritize relational coordination among colleagues in order to support their resilience both at work and at home.</p>","PeriodicalId":47778,"journal":{"name":"Health Care Management Review","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/de/31/hcmr-48-80.PMC9704816.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10725531","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":"Exploring system features of primary care practices that promote better providers' clinical work satisfaction: A qualitative comparative analysis.","authors":"Lingrui Liu,&nbsp;Alyna T Chien,&nbsp;Sara J Singer","doi":"10.1097/HMR.0000000000000334","DOIUrl":"https://doi.org/10.1097/HMR.0000000000000334","url":null,"abstract":"<p><strong>Background: </strong>Health care delivery system features can have a profound effect on how frontline physicians and other clinical personnel in primary care practices (primary care providers [PCPs]) view the quality and safety of what they deliver and, ultimately, their clinical work satisfaction.</p><p><strong>Purpose: </strong>The aim of this study was to investigate the combinations of system features (i.e., team dynamics, provider-perceived safety culture, and patient care coordination between PCPs) that are most conducive to positively enhancing PCPs' clinical work satisfaction.</p><p><strong>Approach: </strong>Nineteen Harvard-affiliated primary care practice sites participated in the Academic Innovations Collaborative 2012-2016, which aimed to establish team-based care and improve patient safety. An All-Staff Survey was administered to 854 PCPs in 2015. The survey measured provider experience of team dynamics, provider-perceived safety culture, patient care coordination between PCPs, and providers' clinical work satisfaction. We performed a qualitative comparative analysis to identify \"recipes,\" that is, combinations of conditions necessary and sufficient for enhancing PCPs' clinical work satisfaction.</p><p><strong>Results: </strong>Strong provider-perceived safety culture and effective team dynamics constitute sufficient conditions that, when present in practices, could best support PCPs to achieve greater clinical work satisfaction.</p><p><strong>Conclusions: </strong>Our findings suggest the importance of creating and sustaining a strong safety culture and of establishing and implementing highly functioning teams in primary care practices for enhancing PCPs' clinical work satisfaction.</p><p><strong>Practice implications: </strong>Conducting the qualitative comparative analysis provides a new perspective for informing primary care and encouraging primary care practices to pursue strategic priorities for enhancing PCPs' clinical work satisfaction and providing safe, high-quality care.</p>","PeriodicalId":47778,"journal":{"name":"Health Care Management Review","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9427665/pdf/nihms-1745120.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10459818","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":"Seen and Heard…at OTHC 2022.","authors":"Larry R Hearld,&nbsp;Cheryl Rathert","doi":"10.1097/HMR.0000000000000353","DOIUrl":"https://doi.org/10.1097/HMR.0000000000000353","url":null,"abstract":"","PeriodicalId":47778,"journal":{"name":"Health Care Management Review","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33445545","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":"Factors associated with patient trust in their clinicians: Results from the Healthy Work Place Study.","authors":"Dhruv Khullar,&nbsp;Kriti Prasad,&nbsp;Hannah Neprash,&nbsp;Sara Poplau,&nbsp;Roger L Brown,&nbsp;Eric S Williams,&nbsp;Crystal Audi,&nbsp;Mark Linzer","doi":"10.1097/HMR.0000000000000336","DOIUrl":"https://doi.org/10.1097/HMR.0000000000000336","url":null,"abstract":"<p><strong>Background: </strong>Patient trust in their clinicians is an important aspect of health care quality, but little evidence exists on what contributes to patient trust.</p><p><strong>Purpose: </strong>The aim of this study was to determine workplace, clinician, and patient correlates of patient trust in their clinician.</p><p><strong>Methodology/approach: </strong>The sample used baseline data from the Healthy Work Place trial, a randomized trial of 34 Midwest and East Coast primary care practices to explore factors associated with patient trust in their clinicians. A multivariate \"best subset\" regression modeling approach was used, starting with an item pool of 45 potential variables. Over 7 million models were tested, with a best subset of correlates determined using standard methods for scale optimization. Skewed variables were transformed to the fifth power using a Box-Cox algorithm.</p><p><strong>Results: </strong>The final model of nine variables explained 38% of variance in patient trust at the patient level and 49% at the clinician level. Trust was related mainly to several aspects of care variables (including satisfaction with explanations, overall satisfaction with provider, and learning about their medical conditions and their clinician's personal manner), with lesser association with patient characteristics and clinician work conditions.</p><p><strong>Conclusion: </strong>Trust appears to be primarily related to what happens between clinicians and patients in the examination room.</p><p><strong>Practice implications: </strong>System changes such as patient-centered medical homes may have difficulty succeeding if the primacy of physician-patient interactions in inspiring patient trust and satisfaction is not recognized.</p>","PeriodicalId":47778,"journal":{"name":"Health Care Management Review","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39927249","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":"Exploring characteristics of specialization as moderators of the link between specialization and patient experience of care.","authors":"Annika Maren Schneider,&nbsp;Eva-Maria Wild","doi":"10.1097/HMR.0000000000000337","DOIUrl":"https://doi.org/10.1097/HMR.0000000000000337","url":null,"abstract":"<p><strong>Background: </strong>Hospitals are increasingly pursuing specialization as a strategy to operate efficiently while delivering high-quality care. To date, however, evidence is lacking on whether hospital specialization has a consistent effect on patients' experience of care or whether different specialization characteristics influence how specialization works.</p><p><strong>Purpose: </strong>This study investigates whether specialization characteristics, that is, the within-specialty concentration and the within-specialty urgency score, moderate the link between hospital specialization and patient experience of care.</p><p><strong>Methodology: </strong>We use patient-reported and administrative data from German hospitals between 2014 and 2017, with orthopedic and trauma care as the research setting. Our sample consists of 157,458 patient observations nested within 483 hospitals. We apply random-intercept multilevel modeling.</p><p><strong>Results: </strong>Our results indicate that the effect of specialization on patient experience of care (a) decreases as the within-specialty concentration increases and (b) increases as the within-specialty urgency score increases.</p><p><strong>Conclusion: </strong>This study provides novel insights into the specialization characteristics that make hospital specialization in orthopedic and trauma care particularly effective at improving patient experiences.</p><p><strong>Practice implications: </strong>Although specialization is gaining popularity as a strategy for pooling scarce resources and facilitating high-quality health care, hospital managers and policymakers should consider that certain characteristics of specialization can influence the way that specialization works and how effective it is in improving patient experiences. Within the scope of orthopedic and trauma care, our study suggests that a low concentration of diagnoses within a service area and a high average level of medical urgency make specialization particularly effective at improving patient experiences.</p>","PeriodicalId":47778,"journal":{"name":"Health Care Management Review","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39900752","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-provider therapeutic connections to improve health care: Conceptual development and systematic review of patient measures.","authors":"Cheryl Rathert,&nbsp;Jessica N Mittler,&nbsp;Yuna S H Lee","doi":"10.1097/HMR.0000000000000339","DOIUrl":"https://doi.org/10.1097/HMR.0000000000000339","url":null,"abstract":"<p><strong>Background: </strong>The Triple Aim (improved population health, improved patient experiences, and lower costs) has influenced U.S. health care since it was introduced in 2008. With it, value-based purchasing has brought unprecedented focus on patient experience measurement. Despite having devoted extensive resources toward improving patient experiences, inconsistent improvements suggest there are some dimensions not yet being widely measured or addressed. Furthermore, a renewed focus on health disparities calls for stronger patient-provider connections in order to reduce health care inequities.</p><p><strong>Purpose: </strong>The aim of this study was to articulate the concept of therapeutic connections (TCs) in health care and examine existing survey measures, from the patient perspective, to learn whether they capture the TC construct.</p><p><strong>Method: </strong>We interviewed subject matter experts ( n = 24) and patients ( n = 22) about measuring TCs and then conducted a systematic review of quantitative measures from three databases using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and COSMIN (COnsensus-based Standards for the selection of health Measurement INstruments) criteria.</p><p><strong>Results: </strong>Of 31 unique measures, none captured all of the theorized TC dimensions. Most were measures of collaboration and shared decision-making or caring.</p><p><strong>Discussion: </strong>Focusing on the nature of patient-provider connections is vital because they are the backbone of most delivery models seeking to achieve the Triple Aim . Further development of the TC concept and measures is warranted to facilitate organizational and financing policies that meaningfully support widespread improvement.</p><p><strong>Practice implications: </strong>A focus on barriers and facilitators of TCs is needed. Without advancing our understanding of the role TCs play in care, policymakers and practitioners will be limited in their ability to make impactful changes.</p>","PeriodicalId":47778,"journal":{"name":"Health Care Management Review","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39927250","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":"Rethinking how health care professionals cope with stress: A process model for COVID-19 and beyond.","authors":"Jason M Harley,&nbsp;Tina C Montreuil,&nbsp;Nigel Mantou Lou,&nbsp;Liane S Feldman,&nbsp;Gerald M Fried,&nbsp;Mélanie Lavoie-Tremblay,&nbsp;Farhan Bhanji,&nbsp;Heather Kennedy","doi":"10.1097/HMR.0000000000000345","DOIUrl":"https://doi.org/10.1097/HMR.0000000000000345","url":null,"abstract":"<p><strong>Issue: </strong>Prior to the COVID-19 pandemic, there was evidence of challenges surrounding the psychological well-being of health care professionals (HCPs). HCPs already frayed psychological ability to cope risks being further compromised by COVID-19-related stresses.</p><p><strong>Critical theoretical analysis: </strong>Most research on stress, psychological distress, and coping among HCPs is done in a piecemeal manner without a theoretical model connecting these different but related phenomena. This critical advancement article aims to apply and extend Wheaton and Montazer's model of stressors, stress, and distress to the literature on HCPs, generally, and COVID-19, specifically, to summarize past and guide future research on HCPs' mental health, resilience, and coping. Our model describes how different sources of support buffer the effect of stressors on stress and how coping strategies moderate the effect of stress on psychological distress.</p><p><strong>Advance: </strong>We extended the model by (a) distinguishing context from the support in HCPs' environment; (b) distinguishing adaptive from maladaptive coping strategies and their relationships with antecedents and outcomes; (c) describing the adverse impacts that psychological distress has on patients, HCPs, and health services; and (d) describing how such outcomes can become stressors, in turn, further contributing to HCPs' stress in a vicious cycle.</p><p><strong>Practice implications: </strong>Our model provides a broader perspective of HCPs' work-related mental health and helps guide the creation, implementation, and evaluation of different sources of support and promote adaptive coping strategies. This model helps HCPs, researchers, and health services managers better understand and respond to the well-being crisis HCPs are facing, especially during the pandemic.</p>","PeriodicalId":47778,"journal":{"name":"Health Care Management Review","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33445546","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":"How psychological safety and feeling heard relate to burnout and adaptation amid uncertainty.","authors":"Michaela J Kerrissey, Tuna C Hayirli, Aditi Bhanja, Nicholas Stark, James Hardy, Christopher R Peabody","doi":"10.1097/HMR.0000000000000338","DOIUrl":"10.1097/HMR.0000000000000338","url":null,"abstract":"<p><strong>Background: </strong>Psychological safety-the belief that it is safe to speak up-is vital amid uncertainty, but its relationship to feeling heard is not well understood.</p><p><strong>Purpose: </strong>The aims of this study were (a) to measure feeling heard and (b) to assess how psychological safety and feeling heard relate to one another as well as to burnout, worsening burnout, and adaptation during uncertainty.</p><p><strong>Methodology: </strong>We conducted a cross-sectional survey of emergency department staff and clinicians (response rate = 52%; analytic N = 241) in July 2020. The survey measured psychological safety, feeling heard, overall burnout, worsening burnout, and perceived process adaptation during the COVID-19 crisis. We assessed descriptive statistics and construct measurement properties, and we assessed relationships among the variables using generalized structural equation modeling.</p><p><strong>Results: </strong>Psychological safety and feeling heard demonstrated acceptable measurement properties and were correlated at r = .54. Levels of feeling heard were lower on average than psychological safety. Psychological safety and feeling heard were both statistically significantly associated with lower burnout and greater process adaptation. Only psychological safety exhibited a statistically significant relationship with less worsening burnout during crisis. We found evidence that feeling heard mediates psychological safety's relationship to burnout and process adaptation.</p><p><strong>Conclusion: </strong>Psychological safety is important but not sufficient for feeling heard. Feeling heard may help mitigate burnout and enable adaptation during uncertainty.</p><p><strong>Practice implications: </strong>For health care leaders, expanding beyond psychological safety to also establish a feeling of being heard may further reduce burnout and improve care processes.</p>","PeriodicalId":47778,"journal":{"name":"Health Care Management Review","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/52/c3/hcmr-47-308.PMC9422764.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39900754","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}