Health Care Management Review最新文献

{"title":"Strategy research in a polarized and politicized environment.","authors":"L Michele Issel, Cheryl Rathert, Larry Hearld","doi":"10.1097/HMR.0000000000000371","DOIUrl":"https://doi.org/10.1097/HMR.0000000000000371","url":null,"abstract":"","PeriodicalId":47778,"journal":{"name":"Health Care Management Review","volume":"48 2","pages":"109"},"PeriodicalIF":2.5,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10779104","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":"A qualitative study of the dark and bright sides of physicians' electronic health record work outside work hours.","authors":"Selasi Attipoe,&nbsp;Daniel M Walker,&nbsp;Sharon B Schweikhart,&nbsp;Jennifer L Hefner","doi":"10.1097/HMR.0000000000000361","DOIUrl":"https://doi.org/10.1097/HMR.0000000000000361","url":null,"abstract":"<p><strong>Background: </strong>The introduction of electronic health records (EHRs) has contributed considerably to EHR work outside work (WOW) hours for physicians. Prior research has identified the pressures associated with stress resulting from EHR WOW, yet developing a nuanced understanding of how physicians appraise and respond to this stress, and the resulting impacts, remains absent from the literature.</p><p><strong>Purpose: </strong>Grounded in the technostress model, this study takes a qualitative approach to explore both the pressures and opportunities associated with EHR WOW.</p><p><strong>Methods: </strong>Thematic analysis of data from semistructured interviews was utilized to examine the pressures and opportunities associated with EHR WOW among primary care pediatricians (n = 15) affiliated with a large Midwestern pediatric health system.</p><p><strong>Results: </strong>The physicians in this study regularly spent time working in the EHR outside work hours. They felt the EHR contributed to their documentation burden, which ultimately increased their EHR WOW, and reported a sense of burden from ubiquitous EHR availability. Conversely, they appreciated the flexibility the EHR provided in terms of work-life balance. Suggestions for improvement under the direct purview of practice management included enhanced EHR usability, improvements in workflow during work hours to free up time to document, and more training on both EHR documentation strategies and ongoing software upgrades.</p><p><strong>Conclusion: </strong>Physicians perceive that the EHR exerts certain pressures while affording new opportunities and conveniences. This study provides evidence of both the pressures and opportunities of EHR WOW and their effect on physician well-being.</p><p><strong>Practice implications: </strong>Specific opportunities are identified for health administrators to enable physicians to better manage EHR WOW.</p>","PeriodicalId":47778,"journal":{"name":"Health Care Management Review","volume":"48 2","pages":"140-149"},"PeriodicalIF":2.5,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10826156","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":"Pursuing innovation in academic medical centers: Models, activities, and influential factors.","authors":"Elana Meer,&nbsp;Iman Ezzeddine,&nbsp;Jessica Chao,&nbsp;Ingrid M Nembhard","doi":"10.1097/HMR.0000000000000363","DOIUrl":"https://doi.org/10.1097/HMR.0000000000000363","url":null,"abstract":"<p><strong>Background: </strong>Academic medical centers (AMCs) are well recognized for their innovations that enhance frontline care, but there is little study of their innovation management processes, which is key for advancing theory regarding the effectiveness of innovation efforts to improve care.</p><p><strong>Purpose: </strong>We aimed to identify organizational models used for frontline innovation by AMCs in the United States, core activities within models, and factors that influence innovation success.</p><p><strong>Methods: </strong>We conducted a qualitative study of 12 AMCs using data from semistructured interviews with centers' innovation leaders. Inclusion required satisfying two of three criteria in 2021 (only met by 35 AMCs nationally): listed in the professional association of innovation leaders (Council of 33), Becker's review of most innovative hospitals, and/or top 20 U.S. News and World Report best hospitals honor roll. We analyzed the interview data using the constant comparative method.</p><p><strong>Results: </strong>Innovative AMCs pursue innovation through innovation centers (using a centralized or multicenter model) or within clinical departments (department-level model). All three models emphasize seven activities, although performed differently: sourcing ideas, developing ideas, implementing innovations, fundraising, managing partnerships, measuring success, and managing mindset. Several factors influenced success: role performance, operational challenges, technology, public policy, customer clarity, stakeholder buy-in, diversity of input, and focus. The centralized model struggled less with standardization and coordination issues.</p><p><strong>Conclusion: </strong>AMCs have options for structuring their innovation efforts. However, there are consistent activities for successful innovation management and factors that they must manage.</p><p><strong>Practice implications: </strong>AMCs can select among innovation models to fit their circumstances but likely need to perform seven activities well for success.</p>","PeriodicalId":47778,"journal":{"name":"Health Care Management Review","volume":"48 2","pages":"161-174"},"PeriodicalIF":2.5,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10831692","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":"Resiliency-based adaptations used by primary care physicians during the COVID-19 pandemic.","authors":"Timothy Hoff,&nbsp;Leah Neff","doi":"10.1097/HMR.0000000000000357","DOIUrl":"https://doi.org/10.1097/HMR.0000000000000357","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic is a profound change event for U.S. primary care physicians and their medical practices.</p><p><strong>Purpose: </strong>We examined how a group of U.S. primary care physicians and their medical practices used resiliency-based strategies, tactics, and mindsets to navigate pandemic-related change over the time period early 2020 through mid-2021.</p><p><strong>Methodology: </strong>A 15-month longitudinal qualitative study of the same 10 physicians interviewed a total of 42 times at four time intervals during the 2020-2021 COVID-19 pandemic. Data were analyzed using a systematic coding approach consisting of first- and second-order code categories feeding into an overall interpretive framework of resiliency-based adaptations.</p><p><strong>Results: </strong>Primary care physicians and their practices engaged in two main resiliency-based strategic adaptations during the pandemic. These adaptations were labeled \"keeping the business afloat\" and \"keeping primary care relevant for patients.\" Each consisted of different strategies and tactics that shared common features including proactiveness, innovativeness, and pragmatism. Specific resiliency-based mindsets were identified that helped physicians both initially engage in needed strategies and tactics while continuing to engage in them over time.</p><p><strong>Conclusions: </strong>The results demonstrate how physicians use resiliency-based adaptation in response to profound change in their environments, defined by behavioral variety and motivated by self-interested and patient-centered imperatives.</p><p><strong>Practice implications: </strong>Physicians are proactive and possess multiple adaptive capabilities. Seen in this more positive light, health care organizations should focus on greater engagement of their physician-employees in implementing innovation in care delivery and managing change, that is, as responsible partners rather than resistors to meeting organizational imperatives.</p>","PeriodicalId":47778,"journal":{"name":"Health Care Management Review","volume":"48 2","pages":"110-119"},"PeriodicalIF":2.5,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9969994/pdf/hcmr-48-110.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9371307","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":"Managing safety in perioperative settings: Strategies of meso-level nurse leaders.","authors":"Joanna Veazey Brooks,&nbsp;Heather Nelson-Brantley","doi":"10.1097/HMR.0000000000000364","DOIUrl":"https://doi.org/10.1097/HMR.0000000000000364","url":null,"abstract":"<p><strong>Background: </strong>Perioperative nursing units are described as one of the most challenging practice environments, characterized by a distinct hierarchal culture and rapid pace. These dynamics create challenges for creating a culture of safety, where meso-level nurse leaders (MLNLs) must operate in the space between the micro level of direct patient care and the macro-level administrative priorities.</p><p><strong>Purpose: </strong>Guided by complexity leadership theory, we sought to understand the strategies MLNLs used to facilitate a culture of safety in perioperative settings.</p><p><strong>Methodology: </strong>A qualitative descriptive study with semistructured interviews was conducted. Inductive thematic analysis was used to analyze content from the interviews, and several techniques (audit trail, reflexivity, peer debriefing) were used to ensure rigor.</p><p><strong>Results: </strong>Seventeen MLNLs completed an interview, and analysis identified four strategies that MLNLs reported to foster safety as meso-leaders in perioperative environments: (a) recognizing the unique perioperative management environment, (b) learning not to take interactions personally, (c) developing \"super meso-level nurse leader\" skills, and (d) appealing to policies and patient safety.</p><p><strong>Conclusion: </strong>Perioperative environments require MLNLs to use multifaceted strategies to keep the peace among many stakeholders and foster patient safety.</p><p><strong>Practice implications: </strong>Our study shows how clear organizational policies and procedures can serve as a vital tool-moving attention away from a feeling of individual \"policing\" and toward joint discussion about shared patient safety goals-and ultimately support MLNLs in challenging perioperative work environments. Perioperative environments create unique challenges, and organizations should consider perioperative-specific leadership training to prepare MLNLs for these roles.</p>","PeriodicalId":47778,"journal":{"name":"Health Care Management Review","volume":"48 2","pages":"175-184"},"PeriodicalIF":2.5,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9387534","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":"Making do by getting real: Psychological contract violations and proactive career agency among medical professionals.","authors":"Mahima Mitra,&nbsp;Sue Dopson,&nbsp;Timothy Hoff","doi":"10.1097/HMR.0000000000000347","DOIUrl":"https://doi.org/10.1097/HMR.0000000000000347","url":null,"abstract":"<p><strong>Background: </strong>Health care professionals face greater uncertainty in their careers as traditional jobs wither and new, organizationally controlled jobs proliferate, reducing economic security and professional autonomy.</p><p><strong>Purpose: </strong>We apply psychological contract and self-efficacy theory to examine the career agency of early-career physicians. We ask the following: (a) What are the unfulfilled expectations and emotions experienced by young physicians at the training and early career stages? (b) What are the forms of career agency exhibited by young physicians in response to unfulfillment?</p><p><strong>Methodology: </strong>We conducted a study on 48 U.K. early-career primary care physicians, known as general practitioners. The sample comprised both trainees as well as newly qualified physicians. Data were collected through in-depth interviews and focus group discussions.</p><p><strong>Results: </strong>Physicians interpreted their early-career experiences based on predominantly ideological expectations around what it means to be a successful professional. However, the realities of practice resulted in highly emotional experiences of violation that were associated with a \"reactive\" agency and job behaviors that were more transactional and less relational.</p><p><strong>Conclusion: </strong>This study identifies the expectations of early career professionals, which helps understand how and why psychological contract violations occur. It also expands the conceptualization of career agency from a positively framed aspect of professional behavior to one that includes haphazard and self-serving elements.</p><p><strong>Practice implications: </strong>Our study highlights several implications of the shifts in physician career agency for primary care practice. It discusses the potential effects of the purposeful self-interest among doctors on professional identity and power, as well as patient care.</p>","PeriodicalId":47778,"journal":{"name":"Health Care Management Review","volume":"48 1","pages":"32-41"},"PeriodicalIF":2.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10734576","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 buffering effects of psychological capital on the relationship between physical violence and mental health issues of nurses and personal care assistants working in aged care facilities.","authors":"Patricia Pariona-Cabrera,&nbsp;Hannah Meacham,&nbsp;Tse Leng Tham,&nbsp;Jillian Cavanagh,&nbsp;Beni Halvorsen,&nbsp;Peter Holland,&nbsp;Timothy Bartram","doi":"10.1097/HMR.0000000000000348","DOIUrl":"https://doi.org/10.1097/HMR.0000000000000348","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to examine the effects of psychological capital on the relationship between physical violence and mental health issues of nurses and personal care assistants (PCAs) working in aged care using the job demands-resources theory.</p><p><strong>Methodology: </strong>Data were collected from 254 nurses and PCAs of the Australian Nursing Midwifery Federation located in Victoria, Australia. The study takes a quantitative approach and tests the hypotheses through regression analyses.</p><p><strong>Findings: </strong>The results indicate that experiencing physical violence increases levels of stress, depression, and anxiety. This, in turn, increases nurses' and PCAs' intention to leave. However, increased psychological capital can assist nurses and PCAs in dealing with physical violence.</p><p><strong>Research implications: </strong>The study acknowledges that physical violence is a factor in nurses' intention to leave. The significant finding is that psychological capital plays a protective role in ameliorating the negative impact of physical violence on individual well-being and intentions to leave. We note, however, that this is a cross-section study, and more longitudinal research needs to be undertaken.</p><p><strong>Practical implications: </strong>There are clear implications for managers to create a supportive organization that cultivates hope, self-efficacy, and resilience, thereby increasing psychological capital. Leadership development programs could build a supportive foundation for nurses to seek support and build resilience. Job construction should be focused on protecting nurses from risk by utilizing manageable workloads to limit stress, depression, and anxiety.</p><p><strong>Originality: </strong>Our study extends research on retention of these skilled and important health care workers in a demanding environment that has largely been absent from the literature. Specifically, physical violence is often considered part of nursing work, but its impact on mental health, well-being, and intention to leave are underexplored in this sector, as well as the effectiveness of specific measures that bolster the negative impact of physical violence on nurses.</p>","PeriodicalId":47778,"journal":{"name":"Health Care Management Review","volume":"48 1","pages":"42-51"},"PeriodicalIF":2.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10728680","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":"Unsafe by design: Infusion task reallocation and safety perceptions in U.S. hospitals.","authors":"Benjamin R Pratt,&nbsp;Benjamin B Dunford,&nbsp;Timothy J Vogus,&nbsp;Ahmad M Ashkanani,&nbsp;Frederick P Morgeson,&nbsp;Mary Alexander","doi":"10.1097/HMR.0000000000000351","DOIUrl":"https://doi.org/10.1097/HMR.0000000000000351","url":null,"abstract":"<p><strong>Background: </strong>Research suggests that changes in nurse roles can compromise perceived organizational safety. However, over the past 15 years, many infusion tasks have been reallocated from specialty nurse infusion teams to individual generalist nurses-a process we call infusion task reallocation . These changes purportedly benefit employees by allowing care providers to practice at the \"top of their license.\" However, job demands-resources theory suggests that changing core task arrangements can either enrich or merely enlarge jobs depending on their effects on demands and resources, with corresponding consequences for performance (e.g., safety). There is relatively little research directly exploring these effects and their mechanisms.</p><p><strong>Purpose: </strong>This study examines the relationship between infusion task reallocation and perceptions of organizational safety. We also explore the extent to which this relationship may be mediated by infusion-related resources and psychological safety.</p><p><strong>Methodology: </strong>Data were collected through a survey of 623 nurses from 580 U.S. hospitals. The relationship between infusion task reallocation and perceptions of organizational safety, as well as the potential mediating roles of infusion-related resources and psychological safety, was examined using structural equation modeling.</p><p><strong>Results: </strong>Infusion task reallocation was negatively associated with respondents' perceptions of organizational safety, with nurses working in organizations without an infusion team indicating lower perceptions of organizational safety than nurses working in organizations with an infusion team. This relationship was mediated by nurse perceptions of psychological safety within the organization, but not by infusion-related resources, suggesting that task reallocation is associated with lower perceived organizational safety because nurses feel less psychologically safe rather than because of perceived technical constraints.</p><p><strong>Practice implications: </strong>The results indicate that, although infusion task reallocation may be a cost-reducing approach to managing clinical responsibilities, it enlarges rather than enriches the job through higher demands and fewer resources for nurses and, in turn, lower perceived organizational safety.</p>","PeriodicalId":47778,"journal":{"name":"Health Care Management Review","volume":"48 1","pages":"14-22"},"PeriodicalIF":2.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10725029","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 dynamics of integration and integrated care: An exploratory study of physician organizations.","authors":"Jonathan R Clark,&nbsp;Maike Tietschert,&nbsp;Michaela Kerrissey,&nbsp;Mark Friedberg,&nbsp;Sara J Singer","doi":"10.1097/HMR.0000000000000356","DOIUrl":"https://doi.org/10.1097/HMR.0000000000000356","url":null,"abstract":"<p><strong>Background: </strong>Substantial variation exists in how well health care is integrated, even across similarly structured organizations, yet research about what physician organizations (POs) do that enables or inhibits integrated care is limited.</p><p><strong>Purpose: </strong>The aim of this study was to explore the dynamics that enable POs to integrate care.</p><p><strong>Methodology/approach: </strong>We ranked a stratified sample of POs according to patient perceptions of integrated care, as measured in a survey. We interviewed professionals, patients, and family members in 10 higher and 3 lower ranked POs about the process of caring for patients with complex conditions. We derived integration-related themes from the interview data and quantified their prevalence. Using a quasi-statistical approach, we explored relationships among themes and their associations with patient perceptions of integrated care.</p><p><strong>Results: </strong>From 6,104 coded references, we derived a set of themes representing integration perspectives, integration engagement mechanisms, and integration failures. POs experienced frequent integration failures. Higher ranked POs experienced these failures less often because of a combination of functional, interpersonal, and stakeholder engagement mechanisms, which appear to complement one another. Integration perspectives, including both people-oriented and systems-oriented mindsets, appear to play a role in generating these integration dynamics.</p><p><strong>Conclusion: </strong>Delivering integrated care depends on a PO's ability to limit integration failures, keeping provider attention focused on patients. Building on the attention-based view, we present a framework suggesting that this ability is a function of both integration perspectives and integration engagement mechanisms.</p><p><strong>Practice implications: </strong>POs interested in delivering more integrated care should employ a variety of complementary integration engagement mechanisms and facilitate these efforts by nurturing both people-oriented and system-oriented mindsets among PO decision-makers.</p>","PeriodicalId":47778,"journal":{"name":"Health Care Management Review","volume":"48 1","pages":"92-108"},"PeriodicalIF":2.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9295244","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 role of health care organizations in patient engagement: Mechanisms to support a strong relationship between patients and clinicians.","authors":"Cynthia J Sieck,&nbsp;Jennifer L Hefner,&nbsp;Daniel M Walker,&nbsp;Natasha Kurien,&nbsp;Lauren Phelps,&nbsp;Ann Scheck McAlearney","doi":"10.1097/HMR.0000000000000346","DOIUrl":"https://doi.org/10.1097/HMR.0000000000000346","url":null,"abstract":"<p><strong>Background: </strong>Patient engagement (PE) is critical to improving patient experience and outcomes, as well as clinician work life and lowering health care costs, yet health care organizations (HCOs) have limited guidance about how to support PE. The engagement capacity framework considers the context of engagement and examines precursors to engagement, including patients' self-efficacy, resources, willingness, and capabilities.</p><p><strong>Purpose: </strong>The aim of this study was to explore clinician and patient perspectives related to mechanisms through with the HCOs can facilitate PE through the lens of the engagement capacity framework.</p><p><strong>Methodology/approach: </strong>We administered an online open-ended survey to clinicians and patient advisors across the United States, including questions focused on the influences of, barriers to, and skills and tools required for PE. A common theme emerged focusing on the role of HCOs in facilitating engagement. Our analysis examined all responses tagged with the \"health care system\" code.</p><p><strong>Results: </strong>Over 750 clinicians and patient advisors responded to our survey. Respondents identified offering advice and support for patients to manage their care (self-efficacy), providing tools to facilitate communication (resources), working to encourage connection with patients (willingness), and training for HCO employees in cultural competency and communication skills (capabilities) as important functions of HCOs related to engagement.</p><p><strong>Conclusion: </strong>HCOs play an important role in supporting a strong partnership between the patient and clinicians. Our study identifies important mechanisms through which HCOs can fulfill this role.</p><p><strong>Practice implications: </strong>HCO leadership and administration can help establish the culture of care provided. Policies and initiatives that provide appropriate communication tools and promote culturally competent care can increase engagement.</p>","PeriodicalId":47778,"journal":{"name":"Health Care Management Review","volume":"48 1","pages":"23-31"},"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/30/c4/hcmr-48-23.PMC9691470.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10734571","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}