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From medical jargon to cultural adaptation: a multidimensional evaluation of AI-powered stroke emergency education tools 从医学术语到文化适应:人工智能卒中应急教育工具的多维评估
IF 3.4 3区 医学
Health Policy and Technology Pub Date : 2025-04-16 DOI: 10.1016/j.hlpt.2025.101018
Cong Wang , Ke Che
{"title":"From medical jargon to cultural adaptation: a multidimensional evaluation of AI-powered stroke emergency education tools","authors":"Cong Wang , Ke Che","doi":"10.1016/j.hlpt.2025.101018","DOIUrl":"10.1016/j.hlpt.2025.101018","url":null,"abstract":"","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":"14 3","pages":"Article 101018"},"PeriodicalIF":3.4,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143851701","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}
引用次数: 0
Efficiency and equity of elderly care service resource allocation in China, 2014–2022 2014-2022年中国养老服务资源配置效率与公平性研究
IF 3.4 3区 医学
Health Policy and Technology Pub Date : 2025-04-15 DOI: 10.1016/j.hlpt.2025.101016
Min Bao , Rongji Ma , Jianqian Chao
{"title":"Efficiency and equity of elderly care service resource allocation in China, 2014–2022","authors":"Min Bao ,&nbsp;Rongji Ma ,&nbsp;Jianqian Chao","doi":"10.1016/j.hlpt.2025.101016","DOIUrl":"10.1016/j.hlpt.2025.101016","url":null,"abstract":"<div><h3>Backgrounds</h3><div>As the aging process in China progresses, the importance and urgency of the appropriate allocation of elderly care service resources are becoming increasingly prominent. This study aims to provide a multidimensional analysis of the efficiency and equity of elderly care resource allocation in China from 2014 to 2022.</div></div><div><h3>Methods</h3><div>Three-stage data envelopment analysis was used to measure efficiency, while Bayesian linear regression and spatial correlation tests were employed to explore the influencing factors and spatial effects of efficiency. The Dagum Gini coefficient decomposition method was applied to assess equity and examine the sources of disparities.</div></div><div><h3>Results</h3><div>From 2014 to 2022, the average efficiency of elderly care service allocation in Chinese provinces showed an increasing trend, rising from 0.469 to 0.602. Spatial correlation tests revealed a global positive spatial correlation among provincial efficiency values, with local clustering observed. The allocation of elderly welfare remained inequitable, with inter-regional differences being the main source of disparities. Conversely, the distribution of bed numbers, end-of-year employee counts and elderly care facility areas remained relatively equitable. The allocation of elderly care institutions and facility numbers transitioned from inequity to moderate equity.</div></div><div><h3>Conclusion</h3><div>From 2014 to 2022, the overall efficiency of elderly care service resource allocation in China was relatively low, with significant inter-provincial differences and evident spatial effects. The allocation of elderly welfare exhibited inequity, primarily due to regional disparities. Policymakers should address the existing regional disparities, strengthen regional cooperation, and scientifically plan the scale and structure of investment in elderly care service resources.</div></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":"14 3","pages":"Article 101016"},"PeriodicalIF":3.4,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143887415","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}
引用次数: 0
Wearable devices and physical activity disparities: Insights from the 2022 Health Information National Trends Survey 可穿戴设备和身体活动差异:来自2022年健康信息全国趋势调查的见解
IF 3.4 3区 医学
Health Policy and Technology Pub Date : 2025-04-14 DOI: 10.1016/j.hlpt.2025.101017
Minjung Lee , Garrett Ash , Soohyun Nam
{"title":"Wearable devices and physical activity disparities: Insights from the 2022 Health Information National Trends Survey","authors":"Minjung Lee ,&nbsp;Garrett Ash ,&nbsp;Soohyun Nam","doi":"10.1016/j.hlpt.2025.101017","DOIUrl":"10.1016/j.hlpt.2025.101017","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to investigate the association between wearable device use and physical activity, as well as to assess the mediating role of wearable device use in the relationship between social disparities and achievement of recommended level of physical activity.</div></div><div><h3>Methods</h3><div>Data from the 2022 Health Information National Trends Survey (HINTS 6) (<em>n</em> = 4922) were analyzed. Weighted prevalence estimates were presented, and adjusted odds ratios from multivariable logistic regression of wearable device use and meeting recommended levels of physical activity were reported. Causal mediation analysis (CMA) was conducted to examine the mediation effect of sociodemographic factors on physical activity via wearable devices.</div></div><div><h3>Results</h3><div>Among participants, 34.9 % used wearable devices, and 37.1 % achieved the recommended level of 150 min of weekly moderate-intensity physical activity. Wearable device users were 1.84 times more likely to achieve recommended physical activity goals than non-users. Significant mediation effects of wearable device use were found, mediating the association between female sex and higher education attainment with physical activity. Furthermore, among wearable users, Asians, and individuals with a body mass index ≥ 30 kg/m<sup>2</sup> were less likely to meet recommended levels of physical activity.</div></div><div><h3>Conclusions</h3><div>Wearable device use exhibit sociodemographic patterns, influencing physical activity and potentially exacerbating health disparities. Promoting equitable usage of wearables and enhancing skills in utilizing wearable devices can significantly enhance physical activity levels, playing a pivotal role in reducing health disparities and fostering overall well-being.</div></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":"14 3","pages":"Article 101017"},"PeriodicalIF":3.4,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143863937","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}
引用次数: 0
Musculoskeletal complaints following hospitalization for COVID-19 infection 因COVID-19感染住院后的肌肉骨骼疾病
IF 3.4 3区 医学
Health Policy and Technology Pub Date : 2025-04-08 DOI: 10.1016/j.hlpt.2025.101012
Mike Ruettermann , Jan Peters , Alexander Kaltenborn , Andre Gutcke , Martin Bergold , Oliver Pieske
{"title":"Musculoskeletal complaints following hospitalization for COVID-19 infection","authors":"Mike Ruettermann ,&nbsp;Jan Peters ,&nbsp;Alexander Kaltenborn ,&nbsp;Andre Gutcke ,&nbsp;Martin Bergold ,&nbsp;Oliver Pieske","doi":"10.1016/j.hlpt.2025.101012","DOIUrl":"10.1016/j.hlpt.2025.101012","url":null,"abstract":"<div><h3>Objectives</h3><div>The term post- or long-COVID syndrome describes &gt;50 possible long-term effects on various organ systems following COVID-19 infection. The pathophysiology of most symptoms remains unclear, and the time course of symptom onset varies widely.</div></div><div><h3>Methods</h3><div>Using a telephone survey and validated questionnaires we investigated the incidence of musculoskeletal complaints after inpatient treatment for COVID-19 infection compared with patients hospitalized for a non-COVID diagnosis.</div></div><div><h3>Results</h3><div>112 patients were followed up for least 6 months after discharge (range 6–21 months). Hospitalized and ICU-treated COVID patients showed significant changes in WOMAC scores for the lower extremities (Kruskal-Wallis test, <em>p</em> = 0.005). There is also a significant change in the post-discharge question about new limb complaints (Chi-squared test, <em>p</em> = 0.005), regardless of whether the patients received intensive care or not. The majority of COVID patients with joint or muscle symptoms describe them as widespread and much less frequently as localized and restricted to one region.</div></div><div><h3>Conclusions</h3><div>In addition to the already known long-term effects, there is evidence that patients with COVID who have been treated in an inpatient setting may also suffer from long-term musculoskeletal effects. Women of working age are particularly affected by the resulting limitations.</div></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":"14 3","pages":"Article 101012"},"PeriodicalIF":3.4,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144070961","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}
引用次数: 0
The influence of digital health technology on the allocation of regional medical resources in China 数字卫生技术对中国区域医疗资源配置的影响
IF 3.4 3区 医学
Health Policy and Technology Pub Date : 2025-04-08 DOI: 10.1016/j.hlpt.2025.101013
Shuqing Chen , Kee-hung Lai , Xitong Guo , Xiaofei Zhang
{"title":"The influence of digital health technology on the allocation of regional medical resources in China","authors":"Shuqing Chen ,&nbsp;Kee-hung Lai ,&nbsp;Xitong Guo ,&nbsp;Xiaofei Zhang","doi":"10.1016/j.hlpt.2025.101013","DOIUrl":"10.1016/j.hlpt.2025.101013","url":null,"abstract":"<div><h3>Objectives</h3><div>Digital health as a service innovation benefits society. However, because of a wide variance in information literacy among individuals, reliance on this technology raises more medical equity issues. This study investigates whether digital health service innovation improves the allocation of medical resources at the regional level in China.</div></div><div><h3>Methods</h3><div>This study collected data from the China Statistical Yearbook and China Health Statistical Yearbook from 2011 to 2020 and an online health service. Then, using the Gini index and a thermal map to analyze the impact of service innovation with digital health on the allocation of medical resources.</div></div><div><h3>Results</h3><div>The results demonstrate that, overall, service innovation with digital health has indeed alleviated the problem of allocation of medical resources, especially in terms of solving the problem of medical resource accessibility in remote or rural areas characterized by poor development. However, at the level of refinement, high-quality medical resources tend to accumulate in economically developed regions. In particular, online high-quality medical resources are concentrated in economically developed first-tier cities. Thus, especially for vulnerable groups, this kind of service innovation with digital health will exacerbate the problem of allocation of medical resources due to the intergenerational digital health literacy divide.</div></div><div><h3>Conclusion</h3><div>Analysis of the advantages and disadvantages of service innovation with digital health is conducive to rational use of medical resources and value creation.</div></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":"14 3","pages":"Article 101013"},"PeriodicalIF":3.4,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143821199","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}
引用次数: 0
Implementation roadmap of health technology assessment in Iran 伊朗卫生技术评估实施路线图
IF 3.4 3区 医学
Health Policy and Technology Pub Date : 2025-04-08 DOI: 10.1016/j.hlpt.2025.101015
Bardia Talebzadeh , Arash Ghazbani , Ahmad Nader Fasseeh , Sanaz Zargar Balaye Jame , Seyyed Ziya Hejrypour , Kimia Karami , Faezeh Sarooeyeh , Masoud Behzadifar , Zoltán Kaló
{"title":"Implementation roadmap of health technology assessment in Iran","authors":"Bardia Talebzadeh ,&nbsp;Arash Ghazbani ,&nbsp;Ahmad Nader Fasseeh ,&nbsp;Sanaz Zargar Balaye Jame ,&nbsp;Seyyed Ziya Hejrypour ,&nbsp;Kimia Karami ,&nbsp;Faezeh Sarooeyeh ,&nbsp;Masoud Behzadifar ,&nbsp;Zoltán Kaló","doi":"10.1016/j.hlpt.2025.101015","DOIUrl":"10.1016/j.hlpt.2025.101015","url":null,"abstract":"<div><h3>Background</h3><div>Health Technology Assessment (HTA) is a relatively new initiative in Iran, compared to high-income countries, but aligns with developments in other middle-income countries. This study aims to design a roadmap for HTA implementation in Iran over the next decade by identifying gaps between the current HTA framework and its desired future state.</div></div><div><h3>Methods</h3><div>The study utilized an HTA implementation scorecard to assess the current state and future goals of HTA across eight key areas: capacity building, funding, organizational structure, scope, decision-making criteria, quality and transparency, use of local data, and international collaboration. 35 stakeholders, selected via convenience sampling, participated in one-on-one interviews. These stakeholders represented organizations such as the Ministry of Health, economic committees, medical universities, and teaching hospitals, ensuring diverse perspectives on HTA and pharmaceutical decision-making.</div></div><div><h3>Results</h3><div>Of the participants, 88.6 % were from the public sector. Regarding HTA education, 28.6 % identified project-based training as prevalent, while 42.9 % noted the existence of permanent graduate programs. A majority (94.1 %) anticipate a more structured HTA education system within the next decade. Public funding was cited as the primary source for HTA report appraisals (68.6 %), though 83 % reported that HTA currently has no formal role in decision-making processes.</div></div><div><h3>Conclusion</h3><div>This study highlights the priorities and challenges in establishing an HTA roadmap for Iran, including political, financial, and infrastructural barriers. The findings emphasize the need for capacity building, enhanced data utilization, and international collaboration to achieve long-term HTA goals. Further research is essential to develop strategies for sustainable HTA implementation in Iran.</div></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":"14 3","pages":"Article 101015"},"PeriodicalIF":3.4,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143844548","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}
引用次数: 0
Bridging the gap: Understanding preferences and perceived benefits of an mHealth app for GDM self-management 弥合差距:了解GDM自我管理的移动健康应用程序的偏好和感知好处
IF 3.4 3区 医学
Health Policy and Technology Pub Date : 2025-04-08 DOI: 10.1016/j.hlpt.2025.101011
Yosefa Birati , Enav Yefet , Lilach Y. Shavit , Sivan Spitzer
{"title":"Bridging the gap: Understanding preferences and perceived benefits of an mHealth app for GDM self-management","authors":"Yosefa Birati ,&nbsp;Enav Yefet ,&nbsp;Lilach Y. Shavit ,&nbsp;Sivan Spitzer","doi":"10.1016/j.hlpt.2025.101011","DOIUrl":"10.1016/j.hlpt.2025.101011","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objectives&lt;/h3&gt;&lt;div&gt;Mobile health (mHealth) solutions to support pregnant women's self-management are increasing. Concerns exist on the extent real-world design and implementation of mHealth applications for pregnant women account for diverse cultural backgrounds and religious practices. This study aimed to (1) explore the challenges in complying and adhering to Gestational diabetes mellitus (GDM) self-management regimens for women from diverse backgrounds; and (2) women's perceptions of culturally tailored features for GDM mHealth apps and their possible contribution in addressing the challenges they experience.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;Semi-structured interviews were conducted on pregnant women diagnosed with GDM in a diabetes-in-pregnancy clinic located in Israel's northern periphery. A content analysis method was used to analyze and interpret the data, and code it into themes.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;A total of 24 pregnant women diagnosed with GDM participated in the study. Of the 24 women, 18 (75 %) were Jewish, 5 (21 %) were Muslims, and 1 (4 %) was Christian. Four main themes were derived from the interviews: (1) GDM self-management challenges (2) Cultural and religious conflicts (3) Experience with the use of digital technologies, and (4) Desirable mHealth features. Common needs included better communication with healthcare providers and dietary guidance. Unique challenges and conflicts arose from cultural and religious practices, such as Ramadan fasting schedules, avoiding technology on the Sabbath for blood sugar monitoring, and unavailable kosher-certified food products that aligned with dietary recommendations. Some women also found apps “too secular” and preferred culturally sensitive features.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;mHealth can improve GDM self-management by integrating culturally tailored features such as fasting-specific guidance, Sabbath-compliant modes, or searchable databases for culturally appropriate nutritional options. Addressing these barriers may enhance adherence and support GDM self-management.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Lay Summary&lt;/h3&gt;&lt;div&gt;Gestational diabetes mellitus (GDM) is a common complication during pregnancy, requiring self-care and lifestyle changes for better control of blood sugar levels. While mobile health (mHealth) solutions supporting healthcare providers and women for improving self-management are becoming popular, existing apps often do not address women's personal or cultural needs. We interviewed pregnant women regarding their experience with digital tools. Women expressed that dietary restrictions and cultural beliefs made it difficult to self-manage their GDM. Yet, they identified that if mHealth apps addressed their personalized treatment plan and allowed asynchronous communication with the healthcare providers it would assist them in managing their GDM. Therefore, mHealth app developers along with health policy, need to promote development and impleme","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":"14 3","pages":"Article 101011"},"PeriodicalIF":3.4,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143828832","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}
引用次数: 0
Diverse structures and methods of national health technology assessment organizations: A scoping review 国家卫生技术评价机构的不同结构和方法:范围审查
IF 3.4 3区 医学
Health Policy and Technology Pub Date : 2025-04-08 DOI: 10.1016/j.hlpt.2025.101009
Celina Borges Migliavaca , Verônica Colpani , Miriam Allein Zago Marcolino , Maicon Falavigna , Carisi Anne Polanczyk
{"title":"Diverse structures and methods of national health technology assessment organizations: A scoping review","authors":"Celina Borges Migliavaca ,&nbsp;Verônica Colpani ,&nbsp;Miriam Allein Zago Marcolino ,&nbsp;Maicon Falavigna ,&nbsp;Carisi Anne Polanczyk","doi":"10.1016/j.hlpt.2025.101009","DOIUrl":"10.1016/j.hlpt.2025.101009","url":null,"abstract":"<div><h3>Objectives</h3><div>To explore the structure and methods of health technology assessment (HTA) organizations.</div></div><div><h3>Methods</h3><div>We included organizations that conduct HTA to inform coverage/reimbursement decisions nationally in any country. Eligible organizations were identified through a systematic search of well-known HTA networks (International Network for Agencies for HTA [INAHTA], European Network for Health Technology Assessment [EUnetHTA], <em>Red de Evaluación de Tecnologías en Salud de las Americas</em> [RedETSA], HTAsiaLink) and references from previous studies evaluating HTA organizations.</div></div><div><h3>Results</h3><div>We identified 69 organizations, from 56 countries. Most organizations are European (<em>n</em> = 39, 56 %) and governmental (<em>n</em> = 53, 77 %). Fifty-one (74 %) advise health authorities, while 13 (19 %) are the ultimate decision-making authority. Of 62 organizations with known funding, all use public resources, and 12 (17 %) charge a fee for evaluation. Healthcare technologies evaluated are medicines (<em>n</em> = 61, 88 %), devices (<em>n</em> = 47, 68 %), and procedures (<em>n</em> = 33, 48 %). Sixty-six organizations (96 %) consider economic factors, with cost-effectiveness and budget impact analyses being the most conducted evaluations. HTA is usually initiated upon the manufacturer's request (<em>n</em> = 45, 65 %). Patient involvement is not clearly described in 32 organizations (46 %), and 2 (3 %) report no involvement; among the remaining, for most (<em>n</em> = 29, 42 %), the role of patients is to provide information to be considered during the decision-making process.</div></div><div><h3>Conclusions</h3><div>Our results underscore the diverse landscape of HTA organizations, highlighting both shared methodologies and unique adaptations, a knowledge that is valuable for countries looking to establish or refine their HTA organizations.</div></div><div><h3>Lay summary</h3><div>Health technology assessment (HTA) is crucial for guiding healthcare decisions and policies around the world. We analyzed 69 organizations from 56 countries that use HTA to inform national coverage and reimbursement decisions. These organizations, primarily government-affiliated, advise on which healthcare technologies—like medications and medical devices—should be funded based mainly on their effectiveness and cost. Despite their common goals, we found significant variation in how they operate, especially in the criteria they use to make recommendations and how they involve stakeholders. Understanding these global practices helps countries improving their own HTA processes, ensuring better healthcare outcomes.</div></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":"14 3","pages":"Article 101009"},"PeriodicalIF":3.4,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143864017","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}
引用次数: 0
Implementing a clinical decision support system in an Aboriginal health service – A qualitative case study 在原住民健康服务中实施临床决策支持系统-定性案例研究
IF 3.4 3区 医学
Health Policy and Technology Pub Date : 2025-04-05 DOI: 10.1016/j.hlpt.2025.101010
Sophie Pascoe , Debbie-Ann Gillon , Paul Kamler , Asanga Abeyaratne , Natasha Pavlin , Gillian Gorham
{"title":"Implementing a clinical decision support system in an Aboriginal health service – A qualitative case study","authors":"Sophie Pascoe ,&nbsp;Debbie-Ann Gillon ,&nbsp;Paul Kamler ,&nbsp;Asanga Abeyaratne ,&nbsp;Natasha Pavlin ,&nbsp;Gillian Gorham","doi":"10.1016/j.hlpt.2025.101010","DOIUrl":"10.1016/j.hlpt.2025.101010","url":null,"abstract":"<div><h3>Objective</h3><div>This qualitative case study aims to evaluate the implementation of a clinical decision support system (CDSS) – Territory Kidney Care (TKC) – at an Aboriginal health service in the Northern Territory (NT) of Australia. This research aims to contribute understandings about the challenges clinicians face when navigating electronic systems within an Aboriginal health service setting and enablers and barriers to the implementation of CDSS.</div></div><div><h3>Methods</h3><div>Within a larger evaluation of TKC, this qualitative case study involved 13 baseline semi-structured interviews completed between October 2022 and January 2023 and seven follow up interviews conducted in June 2023. Through purposive sampling, clinicians in a range of primary care roles participated in the study. Interview transcripts were inductively and iteratively coded by two researchers using a thematic analysis approach.</div></div><div><h3>Results</h3><div>The baseline evaluation found that clinicians working in an Aboriginal health service used multiple electronic health systems, spent considerable time collating patient data across systems and faced challenges related to missing information, technological issues and limited training. The process evaluation of TKC implementation identified that adequate training, a funded Implementation Officer role and supportive leadership were central enablers, while competing clinical priorities, time limitations, staff shortages, access processes were key barriers to uptake and usage.</div></div><div><h3>Conclusions</h3><div>This case study highlights the need for integrated data tools in Aboriginal health services to bridge the gaps between primary, tertiary, government and non-government services. The evaluation emphasises the importance of embedding CDSS within workflows and ensuring there are dedicated staff and resources to facilitate implementation.</div></div><div><h3>Lay Summary</h3><div>This study focuses on how a clinical decision support system was implemented in an Aboriginal health service in the Northern Territory of Australia. Through interviews with clinicians, we identify key barriers and enablers to accessing clinical decision support, as an adjunct to electronic health records. Clinicians in Aboriginal health services must use multiple systems and spend a lot of time looking for information about their patients; a new integrated data platform called Territory Kidney Care was implemented to pull information together from different health services. This research highlights the importance of ensuring there are dedicated staff and resources to help implement new systems.</div></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":"14 3","pages":"Article 101010"},"PeriodicalIF":3.4,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143823224","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}
引用次数: 0
Evaluation of health resources and service utilization in traditional Chinese medicine hospitals in China based on WHO's comprehensive evaluation model 基于WHO综合评价模型的中国中医院卫生资源与服务利用评价
IF 3.4 3区 医学
Health Policy and Technology Pub Date : 2025-03-20 DOI: 10.1016/j.hlpt.2025.100998
Man-ci Zhou , Bing Liu , Qian-tai Gao , Guo-lin Guo , Xuan Wang , Hui-juan Cao , Yu-tong Fei , Jian-ping Liu , Hong-guo Rong
{"title":"Evaluation of health resources and service utilization in traditional Chinese medicine hospitals in China based on WHO's comprehensive evaluation model","authors":"Man-ci Zhou ,&nbsp;Bing Liu ,&nbsp;Qian-tai Gao ,&nbsp;Guo-lin Guo ,&nbsp;Xuan Wang ,&nbsp;Hui-juan Cao ,&nbsp;Yu-tong Fei ,&nbsp;Jian-ping Liu ,&nbsp;Hong-guo Rong","doi":"10.1016/j.hlpt.2025.100998","DOIUrl":"10.1016/j.hlpt.2025.100998","url":null,"abstract":"<div><h3>Background</h3><div>Traditional Chinese medicine (TCM) could contribute to achieving universal health coverage as part of essential healthcare services. This study aimed to evaluate the health resources and services utilization of TCM hospitals in China from 2002 to 2021.</div></div><div><h3>Methods</h3><div>This cross-sectional study analyzed data related to physical resources (hospitals, and beds), human resources (practitioners, licensed (assistant) TCM doctors, and TCM pharmacists), services utilization (outpatient and emergency visits, admission and discharged patients), bed utilization, and health needs of TCM hospitals in China from 2002 to 2021. Data of TCM hospital resources and services utilization were extracted from the China Statistical Yearbooks of Chinese Medicine. The incidence of Class A and B data notifiable infectious diseases were sourced from the National Bureau of Disease Prevention and Control, while maternal and infant mortality rates were obtained from the China Health Statistical Yearbooks. WHO's comprehensive evaluation model and the Rank Sum Ratio (RSR) method were used to rank, and categorize the services provided by TCM hospitals from 2002 to 2021.</div></div><div><h3>Results</h3><div>The number of TCM hospitals, beds, and practitioners in China grew annually, but their proportion was modest, at 15.63 %, 16.15 %, and 16.73 % in 2021. The number of outpatient visits, emergency visits, discharged patients, and admissions in TCM hospitals increased from 253,007 thousand, 15,976 thousand, 8,163 thousand, and 8,205 thousand visits in 2007 to 611,615 thousand, 53,795 thousand, 31,519 thousand, and 31,620 thousand visits in 2021, respectively. The bed occupancy rate in TCM hospitals has been consistently below 85 % since 2015, showing a gradual decrease over time. Between 2007 and 2021, the RSR values for resources and health needs showed continuous growth, reaching over 0.95 in 2021. WHO's comprehensive evaluation model indicated that TCM hospitals experienced high health needs and resources but medium services utilization in 2020 and 2021.</div></div><div><h3>Conclusions</h3><div>Health resources and services utilization of TCM hospitals in China have snowballed, but their share has remained low. Meanwhile, the healthcare services in TCM hospitals have been underutilized. In the future, China should strengthen the provision and utilization of TCM medical services, and improve the utilization rate of healthcare services in TCM hospitals.</div></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":"14 3","pages":"Article 100998"},"PeriodicalIF":3.4,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143704585","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}
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