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Enhancing in-hospital cardiac arrest outcomes through the Tele-ICU Model: A novel approach to CPR quality improvement in India 通过远程icu模式提高院内心脏骤停结果:印度CPR质量改善的新方法
IF 3.4 3区 医学
Health Policy and Technology Pub Date : 2025-09-01 Epub Date: 2025-07-03 DOI: 10.1016/j.hlpt.2025.101062
Sidney Hilker , Vishwanath Koppad , Lokesh MB , Carl Britto , Ryan CL Brewster
{"title":"Enhancing in-hospital cardiac arrest outcomes through the Tele-ICU Model: A novel approach to CPR quality improvement in India","authors":"Sidney Hilker ,&nbsp;Vishwanath Koppad ,&nbsp;Lokesh MB ,&nbsp;Carl Britto ,&nbsp;Ryan CL Brewster","doi":"10.1016/j.hlpt.2025.101062","DOIUrl":"10.1016/j.hlpt.2025.101062","url":null,"abstract":"<div><h3>Introduction</h3><div>In-hospital cardiac arrest is a substantial cause of morbidity and mortality in low- and middle-income countries. Telemedicine intensive care units (Tele-ICUs) may expand critical care capacity, however their impact on cardiac arrest management and outcomes has not been well-defined.</div></div><div><h3>Methods</h3><div>A tele-ICU network established in India provides 24/7 multidisciplinary monitoring and management via real-time audiovisual technology. Between September 2022-November 2023, six partner hospitals underwent tele-ICU implementation and participated in a spaced advanced cardiac life support (ACLS) curriculum, tailored to tele-ICU workflows. The study period spanned from three months prior to the bedside ACLS training (“pre-intervention”) to six months following completion (“post-intervention”). The impact of the intervention on return of spontaneous circulation (ROSC) rates and overall hospital mortality was assessed with multivariable logistic regression and interrupted time series analysis.</div></div><div><h3>Results</h3><div>Among a total of 163 cardiac arrest events (<em>n</em> = 52 pre-intervention, <em>n</em> = 111 pre-intervention), most took place within 5 days of ICU admission (83.4 %) and asystole (61.3 %) was the most common precipitating rhythm. Tele-ICU sites achieved significantly greater ROSC rates during the post-intervention (38.7 %) versus the pre-intervention (19.2 %) periods (adjusted odds ratio [aOR] 3.65 [95 % confidence interval [CI] 1.40–9.53]). This corresponded with an immediate 16.1 % (95 % CI 0.7 %-31.5 %) level increase without a significant trend change (-0.10 % [-0.97 %-0.77 %]). Overall hospital survival remained similar (4.5 % vs. 3.8 %; aOR 0.69 [95 % CI 0.08–5.72]) between study periods.</div></div><div><h3>Conclusions</h3><div>Tele-ICU implementation coupled with targeted ACLS training was associated with improvements in immediate in-hospital cardiac arrest outcomes, highlighting the potential of low-cost, technology-enabled care delivery models to optimize resuscitation performance in LMICs.</div></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":"14 5","pages":"Article 101062"},"PeriodicalIF":3.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144571212","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 digital equity paradox: When good intentions pave the road to technological stratification 数字公平悖论:当善意为技术分层铺平道路时
IF 3.7 3区 医学
Health Policy and Technology Pub Date : 2025-09-01 Epub Date: 2025-07-28 DOI: 10.1016/j.hlpt.2025.101079
Y. Tony Yang
{"title":"The digital equity paradox: When good intentions pave the road to technological stratification","authors":"Y. Tony Yang","doi":"10.1016/j.hlpt.2025.101079","DOIUrl":"10.1016/j.hlpt.2025.101079","url":null,"abstract":"","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":"14 5","pages":"Article 101079"},"PeriodicalIF":3.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144770677","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
Adverse events involving medical devices in Dutch hospitals: A patient record review study 荷兰医院中涉及医疗器械的不良事件:一项患者记录回顾研究
IF 3.4 3区 医学
Health Policy and Technology Pub Date : 2025-09-01 Epub Date: 2025-06-30 DOI: 10.1016/j.hlpt.2025.101063
Mees.C. Baartmans , Steffie.M. van Schoten , Bo Schouten , Linda van Eikenhorst , Renske M. Hoeben , Henk Asscheman , Cordula Wagner
{"title":"Adverse events involving medical devices in Dutch hospitals: A patient record review study","authors":"Mees.C. Baartmans ,&nbsp;Steffie.M. van Schoten ,&nbsp;Bo Schouten ,&nbsp;Linda van Eikenhorst ,&nbsp;Renske M. Hoeben ,&nbsp;Henk Asscheman ,&nbsp;Cordula Wagner","doi":"10.1016/j.hlpt.2025.101063","DOIUrl":"10.1016/j.hlpt.2025.101063","url":null,"abstract":"<div><h3>Objectives</h3><div>To report the incidence of potentially preventable Adverse Events involving a Medical Device (AEMD) and provide an overview of specific topics on how devices were involved in causing patient harm.</div></div><div><h3>Methods</h3><div>A retrospective nationwide patient record review study using randomly selected records of 2998 patients deceased during their admission in 20 Dutch hospitals in 2019.</div></div><div><h3>Results</h3><div>63 potentially preventable AEMDs were identified, corresponding to a weighted incidence of 1.9 % (95CI 1.5 %-2.5 %). Medical devices were involved in about half of all potentially preventable adverse events. Consequences for patients were often severe. Themes in how medical devices were involved in causing patient harm were: Endoscopes causing perforations and hemorrhages, bleedings and infections after placement of heart- and vascular implants, and respiratory harm related to naso- and orogastric tube application. In most cases, the role of the device in causing adverse events was that of prompting a known complication. Preventability in these cases often lied in the subsequent management of the bleeding, perforation or infection.</div></div><div><h3>Conclusions</h3><div>AEMDs occur in a small percentage of patients admitted and deceased in Dutch hospitals, but do represent a substantial part of all potentially preventable adverse events identified amongst the old and severely comorbid patient group in this study. An additional analysis of the data, provided a more thorough understanding of how the use of medical devices contributes to patient harm. Other study designs are necessary to learn more about technical and organizational issues that might trigger AEMDs.</div></div><div><h3>Public interest summary</h3><div>Most medical device applications are safe and effective. Though in a small number of cases an Adverse Event involving a Medical Device (AEMD) occurs. This study found that in 1.9 % (95CI 1.5 %-2.5 %) of patients deceased during their admission in 20 Dutch hospitals in 2019 a potentially preventable AEMD occurred. Identified topics in these AEMDs were perforations, bleedings, and infections after application of endoscopes, heart- and vascular implants, and tubes for enteral feeding or drainage. The role of the devices in these AEMDs was often that of prompting a known complication and considered non-preventable. Preventability in most cases lied in the subsequent management of the perforation, bleeding or infection.</div></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":"14 5","pages":"Article 101063"},"PeriodicalIF":3.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144604772","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
Rural digitalization and health outcomes of older adults in China 中国农村数字化与老年人健康状况
IF 3.4 3区 医学
Health Policy and Technology Pub Date : 2025-09-01 Epub Date: 2025-05-22 DOI: 10.1016/j.hlpt.2025.101038
Kunkun Duan , Jing Li
{"title":"Rural digitalization and health outcomes of older adults in China","authors":"Kunkun Duan ,&nbsp;Jing Li","doi":"10.1016/j.hlpt.2025.101038","DOIUrl":"10.1016/j.hlpt.2025.101038","url":null,"abstract":"<div><div>This study investigates the relationship between rural digitalization and older adults' health conditions. Drawing on the China Longitudinal Aging Social Survey 2020 data, using ordinary least squares (OLS) regression analysis, instrumental variable (IV) methods, and propensity score matching (PSM), the present study finds that rural digitalization significantly improves both physical health (β = 0.295, <em>p</em> &lt; 0.001) and reduces depression propensity score (β = -1.540, <em>p</em> &lt; 0.001). Moreover, the impact of rural digitalization development on older adults' health exhibits differences: older adults (80+) and those using the internet gain more benefits; there is more remarkable support for the physical health of less educated older adults, while mental health support is more pronounced for those with higher education levels. The findings underscore the potential of rural digitalization to mitigate health disparities and advocate for inclusive digital policies tailored to vulnerable older populations.</div></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":"14 5","pages":"Article 101038"},"PeriodicalIF":3.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144147257","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
Spillover effects of pain medication tapering in chronic pain patients: a systematic review and consequences for health economic evaluation studies 慢性疼痛患者止痛药减量的溢出效应:健康经济评价研究的系统回顾和后果
IF 3.4 3区 医学
Health Policy and Technology Pub Date : 2025-09-01 Epub Date: 2025-06-02 DOI: 10.1016/j.hlpt.2025.101037
Frenn Bultinck , Nick Verhaeghe , Max Lelie , Bo Vandenbulcke , Elke Wuyts , Cleo L. Crunelle , Lisa Goudman , Maarten Moens , Koen Putman
{"title":"Spillover effects of pain medication tapering in chronic pain patients: a systematic review and consequences for health economic evaluation studies","authors":"Frenn Bultinck ,&nbsp;Nick Verhaeghe ,&nbsp;Max Lelie ,&nbsp;Bo Vandenbulcke ,&nbsp;Elke Wuyts ,&nbsp;Cleo L. Crunelle ,&nbsp;Lisa Goudman ,&nbsp;Maarten Moens ,&nbsp;Koen Putman","doi":"10.1016/j.hlpt.2025.101037","DOIUrl":"10.1016/j.hlpt.2025.101037","url":null,"abstract":"<div><h3>Background</h3><div>Spillover effects of pain medication tapering (PMT) programs in patients with chronic pain (CP) are underexplored. This systematic review presents current research on the study of spillover effects of PMT in patients with CP and provides suggestions for examination of spillover effects in health economic research of PMT. Understanding spillover effects enable wide-ranging assessment of interventions, including its broader impacts.</div></div><div><h3>Methods</h3><div>Literature was searched up to September 2023 in Web of Science, PubMed, Scopus, Embase, PsychINFO, APA PsychNet, Cochrane library, Econlit, and grey literature sources including Google Scholar, CADTH, Mednar and the WHO website. QualSyst was used for Risk of bias assessment. The study protocol was registered prospectively in PROSPERO (CRD42023461763). Results were classified into five domains and incorporated into the expanded impact inventory framework. No funding was obtained.</div></div><div><h3>Results</h3><div>Of 2099 records initially identified, six qualitative studies of varying quality were included. In the healthcare domain, additional demands on healthcare delivery, patients switching between healthcare providers and psychosocial impacts for healthcare providers were key findings. Scientific spillovers entailed evidence-based recommendations, enhanced PMT awareness and knowledge dissemination. Sociological effects encompassed bias affecting underrepresented groups and community-level benefits. No spillovers were found in other categories. Future research should extend beyond patient-centered outcomes to comprehensively assess PMT’s societal impact and reveal indirect benefits currently underrepresented in the literature.</div></div><div><h3>Conclusions</h3><div>Spillover effects of PMT in patients with CP were identified. Considering spillovers can allow policymakers to optimize healthcare policies and resource allocation in healthcare. Inclusion of only six studies is a limitation of this study.</div></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":"14 5","pages":"Article 101037"},"PeriodicalIF":3.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144254395","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 effectiveness of mobile health applications on the quality of life of hypertension patients: A systematic review and meta-analysis 移动健康应用程序对高血压患者生活质量的影响:系统回顾和荟萃分析
IF 3.4 3区 医学
Health Policy and Technology Pub Date : 2025-09-01 Epub Date: 2025-07-03 DOI: 10.1016/j.hlpt.2025.101064
Nouran Hamza , Wael Hafez , Sara Adel Abdelkader Saed , Marina Raouf , Nesma Magdi , Sahar Allam , Rahma Sweedy , Dina Alaraby , Marwa Muhammed Abdeljawad , Nouran A. Taha
{"title":"The effectiveness of mobile health applications on the quality of life of hypertension patients: A systematic review and meta-analysis","authors":"Nouran Hamza ,&nbsp;Wael Hafez ,&nbsp;Sara Adel Abdelkader Saed ,&nbsp;Marina Raouf ,&nbsp;Nesma Magdi ,&nbsp;Sahar Allam ,&nbsp;Rahma Sweedy ,&nbsp;Dina Alaraby ,&nbsp;Marwa Muhammed Abdeljawad ,&nbsp;Nouran A. Taha","doi":"10.1016/j.hlpt.2025.101064","DOIUrl":"10.1016/j.hlpt.2025.101064","url":null,"abstract":"<div><h3>Background</h3><div>The complexity and burden of hypertension management necessitate innovative strategies to improve care quality and patient outcomes. Our meta-analysis aimed to evaluate the impact of e-health interventions on hypertension patients' quality of life and medication adherence.</div></div><div><h3>Methods</h3><div>A systematic review and meta-analysis were conducted using medical electronic databases for literature published before June 30, 2023. Studies investigating the efficacy of mobile health applications on the quality of life of hypertension patients were included. We extracted the studies’ characteristics, patient descriptions, and efficacy outcomes of mobile health applications. Quality assessment was done using ROB 2 and ROBINS-I V2. A meta-analysis was conducted using RevMan software.</div></div><div><h3>Results</h3><div>The intervention significantly decreased the standardized mean difference of the systolic blood pressure (SBP) measures compared to the control (SMD=-0.43; 95 % CI= -0.52, -0.17; <em>p</em> &lt; 0.01). Additionally, it significantly increased the odds of blood pressure control (OR=3.05; 95 %CI=1.42, 6.54; <em>p</em> &lt; 0.01). The heterogeneity was high; therefore, sensitivity and subgroup analyses were conducted: The intervention significantly increased the quality of life score of hypertension patients compared to the control (SMD=0.19; 95 % CI=0.04, 0.33; <em>p</em> = 0.01). It also significantly decreased the SMD of the SBP change from baseline and the diastolic blood pressure change from baseline compared to the control [(SMD=-4.29; 95 % CI= -5.05, -3.52; <em>p</em> &lt; 0.01), (SMD=-2.75; 95 % CI= -4.06, -1.45; <em>p</em> &lt; 0.01), respectively].</div></div><div><h3>Conclusion</h3><div>Our study demonstrates the efficacy of e-health interventions in promoting hypertension self-management, highlighting their potential as a scalable and accessible tool among the mobile phone-using population.</div></div><div><h3>Public Interest Summary</h3><div>Hypertension is a serious disease with severe complications if left uncontrolled. Our goal was to collect all available data on using mobile health applications in hypertension patients to facilitate their medication adherence and thus improve their quality of life. Our results show a noticeable enhancement in blood pressure control and increased patients’ quality of life after using these mobile health applications. This synthesized evidence can help patients and their healthcare providers recognize the strong efficacy and promising outcomes of these applications across multiple studies, which can ultimately lead to widespread utilization and more benefits to patients.</div></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":"14 5","pages":"Article 101064"},"PeriodicalIF":3.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144595837","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
Lowering inequality in access to emergency contraception: The effect of a Chilean public policy 降低获得紧急避孕方面的不平等:智利一项公共政策的影响
IF 3.4 3区 医学
Health Policy and Technology Pub Date : 2025-09-01 Epub Date: 2025-06-28 DOI: 10.1016/j.hlpt.2025.101066
Sebastián Lavanderos , Andrea Morales , Camilo Riquelme , Juan Haase
{"title":"Lowering inequality in access to emergency contraception: The effect of a Chilean public policy","authors":"Sebastián Lavanderos ,&nbsp;Andrea Morales ,&nbsp;Camilo Riquelme ,&nbsp;Juan Haase","doi":"10.1016/j.hlpt.2025.101066","DOIUrl":"10.1016/j.hlpt.2025.101066","url":null,"abstract":"<div><h3>Objectives</h3><div>To evaluate the impact of legal changes, specifically Law 20.418, on reducing inequality in emergency contraception (EC) access in Chile between 2008 and 2013.</div></div><div><h3>Methods</h3><div>A longitudinal, retrospective analysis was conducted using data from the Monthly Statistical Record (REM) of the Chilean Ministry of Health. EC consultation rates were calculated for ambulatory and total consultations, including rape-related cases, across communes. Inequality was assessed using Lorenz curves and four inequality indicators: Gini index, Theil index, coefficient of variation, and 75/25 ratio.</div></div><div><h3>Results</h3><div>The study found a significant reduction in communal inequality in EC consultations after the implementation of Law 20.418 in 2010. Between 2008 and 2013, the Gini index for ambulatory consultations decreased by 41 %, while for total consultations, it dropped by 20 %. Other inequality indicators also showed substantial decreases, with the 75/25 ratio decreasing by 73 % for ambulatory consultations. Regional analysis revealed a consistent downward trend in inequality, with the most significant improvements occurring in areas with higher consultation rates.</div></div><div><h3>Conclusions</h3><div>The findings indicate that the legal reforms introduced by Law 20.418 contributed to reducing disparities in EC access across communes. Despite improvements, some residual inequalities persist, highlighting the need for further research to identify and address remaining barriers to equitable EC access in certain regions.</div></div><div><h3>Lay Summary</h3><div>This study evaluates the impact of Chile's Law 20.418, which mandated the provision of emergency contraception (EC) in the public health system, on reducing access inequality. Data from 2008 to 2013 show a significant decrease in inequality in EC consultations across communes. The Gini index and other inequality indicators revealed improvements, with a 41 % reduction in inequality for ambulatory consultations and a 20 % reduction for total consultations. These changes are linked to the law's implementation, which expanded EC access, particularly in rural and underserved areas. Despite the progress, some disparities remain, suggesting that while policy interventions have made access more equitable, further efforts are needed to address residual barriers. This study highlights the importance of legal frameworks in promoting health equity, particularly in reproductive healthcare.</div></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":"14 5","pages":"Article 101066"},"PeriodicalIF":3.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144549378","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
Benefits and challenges of high-density microarray patches for vaccination among older adults: A qualitative study 老年人接种高密度微阵列贴片的益处和挑战:一项定性研究
IF 3.4 3区 医学
Health Policy and Technology Pub Date : 2025-09-01 Epub Date: 2025-07-01 DOI: 10.1016/j.hlpt.2025.101065
Matthew N. Berger , Sara L. Knox , Ben Baker , Benjamin G. Stewart , Charles Ross , Erin Mathieu , Angus H. Forster , S.Rachel Skinner , Cristyn Davies
{"title":"Benefits and challenges of high-density microarray patches for vaccination among older adults: A qualitative study","authors":"Matthew N. Berger ,&nbsp;Sara L. Knox ,&nbsp;Ben Baker ,&nbsp;Benjamin G. Stewart ,&nbsp;Charles Ross ,&nbsp;Erin Mathieu ,&nbsp;Angus H. Forster ,&nbsp;S.Rachel Skinner ,&nbsp;Cristyn Davies","doi":"10.1016/j.hlpt.2025.101065","DOIUrl":"10.1016/j.hlpt.2025.101065","url":null,"abstract":"<div><h3>Objectives</h3><div>Microarray Patches (MAPs) deliver vaccines to the upper dermis and epidermis, rich in immune cells. This study explored the perceived safety, usability, and acceptability of High-Density Microarray Patches (HD-MAPs) among older adults aged 50+.</div></div><div><h3>Methods</h3><div>This was a single-centre, single-arm, open-label study using excipient-coated HD-MAPs. A trained user administered two HD-MAPs to each participant’s dominant arm, and participants self-administered to their non-dominant arm. Semi-structured interviews were conducted on days 0 and 28. Thematic analysis was used to explore participant experiences.</div></div><div><h3>Results</h3><div>Forty-four older adults were recruited. Themes explored the benefits and challenges of HD-MAPs. Benefits included (1) mass distribution and administration, (2) reduced healthcare burden, and (3) convenience, particularly in low-resource settings due to thermostability and potential for self-administration. Participants felt that use of trained users and self-administration could reduce burden on healthcare resources. Challenges highlighted were (1) safety of unsupervised use, (2) proof of vaccination, and (3) user confidence and cost. Concerns about adverse events and correct dosage were raised, though participants felt reassured by the sensation, applicator sound, and mark after application.</div></div><div><h3>Conclusion</h3><div>HD-MAPs may ease healthcare burdens and improve convenience and acceptability among older adults, offering an alternative to needles and syringes, especially for vulnerable populations.</div></div><div><h3>Lay summary</h3><div>This study explored how older adults (aged 50+) perceived the safety, usability, and acceptability of High-Density Microarray Patches (HD-MAPs), a new, needle-free vaccine delivery method. Participants received the HD-MAP from a trained user and also tried self-administering it. Most found HD-MAPs convenient and easy to use, appreciating their potential for home use and application in remote areas without refrigeration. Participants liked the idea of reducing the burden on healthcare systems and found the HD-MAPs less intimidating than needles. However, some concerns were raised, including safety when used unsupervised, confirming successful vaccine delivery, and cost. Participants suggested using telehealth or supervised settings to enhance confidence. Overall, HD-MAPs were considered a promising vaccination alternative, especially during pandemics and in low-resource settings. The technology may help increase vaccination rates in older adults by offering more accessible, less painful options.</div></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":"14 5","pages":"Article 101065"},"PeriodicalIF":3.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144581157","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
Dynamic decision system for ENT surgery waiting list prioritization using M-Score and TOPSIS methodology 基于M-Score和TOPSIS方法的耳鼻喉外科候诊名单优先排序动态决策系统
IF 3.4 3区 医学
Health Policy and Technology Pub Date : 2025-09-01 Epub Date: 2025-06-03 DOI: 10.1016/j.hlpt.2025.101036
Fabián Silva-Aravena, Jenny Morales
{"title":"Dynamic decision system for ENT surgery waiting list prioritization using M-Score and TOPSIS methodology","authors":"Fabián Silva-Aravena,&nbsp;Jenny Morales","doi":"10.1016/j.hlpt.2025.101036","DOIUrl":"10.1016/j.hlpt.2025.101036","url":null,"abstract":"<div><div>Objective: This study aims to develop and evaluate a dynamic prioritization system to improve surgical waiting list management for otorhinolaryngology (ENT) patients in a high-complexity public hospital in Chile. The proposed model aims to reduce waiting times and improve equity and clinical outcomes by dynamically incorporating changes in patient condition. Methods: We implemented a dynamic scoring system (M-Score), updated weekly using multidimensional biopsychosocial criteria, and integrated it with the Technique for Order Preference by Similarity to Ideal Solution (TOPSIS) to prioritize patients. The evaluation was carried out using Monte Carlo simulations over a 52-week horizon, simulating patient inflows and outflows via a balanced flow model. The stability and performance of the proposed model were compared with a static model and a traditional first-come, first-served (FCFS) protocol. Results: The proposed approach reduced the average waiting time from 130 to 91 days compared to the static model (a 30 % relative and absolute decrease of 39 days) and from 157 to 91 days compared to FCFS (a 42 % relative and absolute reduction of 66 days). The greatest improvements were observed among high-risk patients, whose prioritization was adapted in real time to worsening clinical conditions. Conclusions: Our adaptive prioritization model demonstrates significant improvements in waiting time management, particularly for clinically vulnerable patients. Although the findings support its feasibility, further prospective validation is necessary before clinical implementation. Future research should focus on real-time integration with electronic medical records, scalability between specialties, and evaluation of impacts on patient satisfaction and health outcomes. Lay Summary: ENT patients in public hospitals often face long waiting times that increase health risks. This study introduces a weekly update to the prioritization model using social and health factors of the patient. The system reduced average waiting times by up to 66 days in simulation. High-risk patients were prioritized as their conditions worsened. This approach offers a promising data-driven strategy for improving waitlist management and resource allocation in public healthcare.</div></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":"14 5","pages":"Article 101036"},"PeriodicalIF":3.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144330586","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
How has Aggregated Mobility Data-informed public health research? 综合流动数据如何为公共卫生研究提供信息?
IF 3.4 3区 医学
Health Policy and Technology Pub Date : 2025-09-01 Epub Date: 2025-06-08 DOI: 10.1016/j.hlpt.2025.101055
Jennifer Turnnidge , Oluwatoyosi Kuforiji , Sina Sayyad , Sarah Greco , Sawmmiya Kirupaharan , Angélique Roy , Nancy Dalgarno , Angel Zhou , Mir Sanim Al Mamun , Hiroshi Mamiya , Khai Hoan Tram , Sahar Saeed
{"title":"How has Aggregated Mobility Data-informed public health research?","authors":"Jennifer Turnnidge ,&nbsp;Oluwatoyosi Kuforiji ,&nbsp;Sina Sayyad ,&nbsp;Sarah Greco ,&nbsp;Sawmmiya Kirupaharan ,&nbsp;Angélique Roy ,&nbsp;Nancy Dalgarno ,&nbsp;Angel Zhou ,&nbsp;Mir Sanim Al Mamun ,&nbsp;Hiroshi Mamiya ,&nbsp;Khai Hoan Tram ,&nbsp;Sahar Saeed","doi":"10.1016/j.hlpt.2025.101055","DOIUrl":"10.1016/j.hlpt.2025.101055","url":null,"abstract":"<div><h3>Objective</h3><div>The widespread adoption of smartphones has enabled the collection and analysis of population-level mobility patterns through Aggregated Mobility Data. This type of data, which is derived from both operator and crowdsourced sources, presents opportunities and challenges for public health research. This data derived from both operator and crowdsourced sources, presents opportunities and challenges for public health research. We explore how this novel data source has been used in public health studies, its benefits, limitations, and ethical considerations.</div></div><div><h3>Methods</h3><div>We conducted a narrative review of Aggregated Mobility Data applications in public health research, critically examining its potential and challenges. A systematic search of Embase and Google Scholar identified 645 peer-reviewed primary research articles. We included English peer-reviewed and primary research published between 2010–2024 where aggregated mobility data was being used to evaluate a public health outcome. After applying inclusion criteria, 95 studies were included for narrative synthesis and descriptive quantitative analysis.</div></div><div><h3>Results</h3><div>We found the majority of studies to date using Aggregated Mobility Data were related to COVID-19. Reporting of ethical and privacy considerations varied widely, with some studies undergoing formal ethics review and others citing exemptions based on the use of anonymized or aggregate data. Key limitations of Aggregated Mobility Data included restricted access to data sources and challenges associated with small population sizes.</div></div><div><h3>Conclusion</h3><div>This review underscores the potential of Aggregated Mobility Data in public health research and highlights key considerations for researchers and policymakers. Future studies should address ethical standardization, data accessibility, and broader applications beyond infectious disease surveillance to fully leverage the utility of Aggregated Mobility Data in public health decision-making.</div></div><div><h3>Public Interest Summary</h3><div>With the rise of smartphones, researchers can now track population movement using Aggregated Mobility Data from mobile devices. This data has been widely used in public health, especially during COVID-19, to understand how people move and how that impacts disease spread. However, access to this data is often restricted, and ethical considerations like privacy protections vary across studies. Our review examined 95 studies to assess the applications in public health research. While this data offers valuable insights, future research should focus on standardizing ethical guidelines, improving data access, and expanding its use beyond infectious disease tracking to other public health challenges.</div></div>","PeriodicalId":48672,"journal":{"name":"Health Policy and Technology","volume":"14 5","pages":"Article 101055"},"PeriodicalIF":3.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144563636","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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