Milbank Quarterly最新文献

{"title":"Review of Emergent Financing Models for Mental Health Crisis Systems.","authors":"Jonathan Purtle, Amanda I Mauri, David Frederick","doi":"10.1111/1468-0009.70014","DOIUrl":"https://doi.org/10.1111/1468-0009.70014","url":null,"abstract":"<p><p>Policy Points The sources and adequacy of funding for crisis systems currently varies significantly among the US states and across services in the crisis continuum. Crisis services are funded by a wide range of sources, including 988 telecom fees and other state appropriations, community mental health services block grants and other federal funding sources, Medicaid, and commercial insurance. Priority areas for research related to financing crisis systems include evaluating the effects of 988 telecom fees, value-based payment models, and non-Medicaid payors.</p>","PeriodicalId":49810,"journal":{"name":"Milbank Quarterly","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144056343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"State Policy Strategies to Promote the Recruitment and Retention of the Behavioral Health Workforce.","authors":"Briana S Last, Jane M Zhu","doi":"10.1111/1468-0009.70013","DOIUrl":"https://doi.org/10.1111/1468-0009.70013","url":null,"abstract":"<p><p>Policy Points To address persistent gaps in behavioral health care access and availability, particularly for underresourced populations, state policymakers have implemented four core strategies to address the shortage of behavioral health providers serving the Medicaid population. In this paper, we describe each of these state policy strategies, discuss their potential workforce and service impacts, and highlight unanswered questions about their effectiveness and implementation. Altogether, our review of these policy strategies suggests that rigorous evaluation of these state policy strategies is needed along with broader transformations to the behavioral health system to sustainably grow and retain the workforce in the long term.</p>","PeriodicalId":49810,"journal":{"name":"Milbank Quarterly","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144051888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Scaling an Evidence-Based Community Health Worker Program With Fidelity: Results and Lessons Learned.","authors":"Molly Knowles, Aditi Vasan, Ziwei Pan, Judith A Long, Shreya Kangovi","doi":"10.1111/1468-0009.70011","DOIUrl":"https://doi.org/10.1111/1468-0009.70011","url":null,"abstract":"<p><p>Policy Points Effectively implemented community health worker (CHW) programs improve patient health outcomes and quality of care, reduce health care costs, and are a key strategy for addressing social and structural drivers of health. As policymakers consider funding mechanisms for CHW programs, it is crucial to tie funding to evidence-based best practices while also allowing for innovation and context-specific adaptations.</p><p><strong>Context: </strong>Community health worker (CHW) programs represent a key strategy for addressing social and structural drivers of health and have the potential to improve patient health outcomes and enhance quality of care while reducing health care costs. However, challenges such as high staff turnover, lack of program infrastructure, and inadequate CHW support and supervision can hinder implementation and sustainment of effective CHW programs. Furthermore, few CHW programs have been successfully scaled across multiple organizations and communities. Individualized Management for Person-Centered Targets (IMPaCT) is an evidence-based CHW model designed to address these challenges by standardizing processes for CHW hiring, training, support, and supervision while still allowing for context-specific adaptation and tailoring. In this dissemination and implementation project, we evaluated implementation of IMPaCT across five geographically and structurally distinct sites serving diverse and varied patient populations.</p><p><strong>Methods: </strong>Model fidelity was assessed across seven best practice domains via structured virtual observations with CHWs, supervisors, and program directors at each implementation site. Acute care use was evaluated using difference-in-differences regression modeling for patients enrolled in IMPaCT compared with a propensity score-matched control group. All implementation sites examined total hospital days per patient, and several sites chose to incorporate additional measures of acute care use such as the number of hospitalizations and emergency department visits.</p><p><strong>Findings: </strong>We found that core program components were implemented consistently across sites, and three of five sites were able to both sustain implementation over a three-year period and demonstrate significant reductions in acute care use, consistent with previous randomized controlled trials of this program.</p><p><strong>Conclusions: </strong>Health systems may be able to address social drivers of health and improve population health for patients who are low-income and patients of color by implementing evidence-based CHW programs with fidelity.</p>","PeriodicalId":49810,"journal":{"name":"Milbank Quarterly","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143995757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reported Strategies by Medicaid Managed Care Organizations to Improve Access to Behavioral Health Services.","authors":"Jane M Zhu, Ruth Rowland, Inga Suneson, Deborah J Cohen, K John McCONNELL, Daniel Polsky","doi":"10.1111/1468-0009.70009","DOIUrl":"https://doi.org/10.1111/1468-0009.70009","url":null,"abstract":"&lt;p&gt;&lt;p&gt;Policy Points Despite the growing role of managed care organizations (MCOs) in financing and delivering behavioral health services in Medicaid, little is known about MCO strategies to overcome critical access barriers and the factors influencing these strategies. Through semistructured interviews of 27 administrators and executives across 19 local, regional, and national Medicaid MCOs, we describe a number of reported approaches to enhance behavioral health access: 1) contracting with core groups of Medicaid-focused behavioral health providers to provide a substantial share of care, and 2) targeted strategies to enhance the existing workforce through outreach, training, and workforce support programs; rate enhancements; telehealth and mobile unit care models; and high-touch case management. Findings highlight MCO perspectives on barriers and facilitators of access to behavioral health care, as well potential strategies that hold promise for other MCOs. Future research should evaluate the outcomes associated with these strategies and identify best practices that can be adapted across MCOs.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Context: &lt;/strong&gt;Behavioral health access gaps are well documented in Medicaid, in which managed care now covers most enrollees, and for which there are typically fewer options for going out-of-network for care. Despite the growing role of managed care organizations (MCOs) in financing and delivering behavioral health services, little is known about MCO levers that can improve access to care.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We interviewed 27 administrators and executives across 19 Medicaid MCO carriers with local, regional, or national operating presence to understand strategies to address behavioral health access barriers and the factors influencing these strategies. To achieve maximum heterogeneity, we employed iterative purposive sampling using a sampling matrix of plan and state characteristics. One-hour interviews were recorded, professionally transcribed, and analyzed using a coding scheme that was developed iteratively. Codes were bundled into major themes after iterative discussions, with analysis conducted at the MCO level.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Findings: &lt;/strong&gt;MCOs perceived acute access challenges for children and adolescents, rural geographies, and crisis and transitional services. To address these challenges, MCOs reported contracting with core groups of Medicaid-focused behavioral health providers, supplemented with targeted strategies to enhance the existing workforce. These strategies focused on enhancing provider retention and capacity through outreach, training, and workforce support programs; rate enhancements; telehealth and mobile unit care models; and high-touch case management to align members to appropriate providers or service levels. Strategies were influenced by state policy contexts, including by regional financing and organization of behavioral health services, rate setting procedures, and administrative and regulator","PeriodicalId":49810,"journal":{"name":"Milbank Quarterly","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144023230","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What Happened in Delaware Following a Statewide Contraceptive Initiative?","authors":"Constanza Hurtado-Acuna, Michael S Rendall","doi":"10.1111/1468-0009.70008","DOIUrl":"https://doi.org/10.1111/1468-0009.70008","url":null,"abstract":"<p><p>Policy Points The 2015 to 2020 Delaware Contraceptive Access Now (DelCAN) initiative followed other long-acting reversible contraception-focused contraceptive initiatives in Colorado and in St. Louis, Missouri. and preceded statewide contraceptive-access initiatives in South Carolina, Massachusetts, and North Carolina with additional initiatives planned. Our principle conclusion is that the DelCAN did not achieve its goal of reducing the fraction of births from unintended pregnancies. However, we find evidence of a substantial magnitude of decrease in unplanned pregnancies that can be attributed to the initiative, and that this decrease occurred entirely among Medicaid-covered women.</p><p><strong>Context: </strong>The 2015 to 2020 Delaware Contraceptive Access Now (DelCAN) initiative was motivated by Delaware's having among the highest rates of unintended pregnancies in the United States, of which were either wanted later or unwanted. The expectation of the DelCAN initiative was that by providing greater contraceptive access, especially to long-acting reversible contraception, Delaware's unintended-pregnancy rates could be substantially reduced. In this study, we assess the role of the DelCAN in explaining, for live births, changes in women's pregnancy intentions around the time of conception.</p><p><strong>Methods: </strong>We examine not only pregnancy intentions, but also the planned status of the pregnancies, including whether the woman was trying to get pregnant and whether she or her partner was using contraception when an unplanned pregnancy occurred. We use the Pregnancy Risk Assessment Monitoring System data with difference-in-difference estimators to compare Delaware with six states in 2007 to 2020 with respect to the planned status of pregnancies ending in births and with 14 states in 2012 to 2020 with respect to the intended status of pregnancies ending in births. Because several components of the DelCAN were designed to facilitate contraceptive access for low-income women, we conduct both an overall analysis and separate analyses for Medicaid-covered and non-Medicaid-covered women.</p><p><strong>Findings: </strong>The DelCAN was not associated with reductions in unintended pregnancies ending in births in Delaware relative to comparison states but was associated with an increase in pregnancies that were wanted sooner. DelCAN was also associated with an increase in planned pregnancies concentrated among Medicaid-insured women and produced through reductions in pregnancies occurring when not using contraception.</p><p><strong>Conclusions: </strong>Pregnancy intentions and pregnancy planning should be treated as distinct concepts in contraceptive-access program design and evaluation. Programs should attend to both pregnancies wanted later and pregnancies wanted sooner to address public health goals in concert with enhancing women's reproductive autonomy.</p>","PeriodicalId":49810,"journal":{"name":"Milbank Quarterly","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143812861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Long Arc of Substance Use Policy Innovation in Medicaid: Looking Back, Looking Forward.","authors":"Brendan Saloner","doi":"10.1111/1468-0009.70007","DOIUrl":"10.1111/1468-0009.70007","url":null,"abstract":"<p><p>Policy Points The role of Medicaid in financing, organizing, and delivering substance use disorder (SUD) treatment has grown tremendously over time owing to expansions of eligibility and a push toward more uniformity in benefits. Current innovations in SUD treatment focus on expanding the delivery system to create a comprehensive continuum of care, using more value-based payment to reward quality care, and integrating SUD treatment with other systems (e.g., housing, employment, and the criminal legal system). Many of the promising innovations in delivery have not yet been rigorously studied, and implementation of effective models is often stymied because of the lack of flexibility in program requirements and variation in needs and resources across communities. Although policymakers can justifiably laud the great strides Medicaid has made in raising the standards for SUD treatment, there is a huge remaining gap in access to services amidst an unprecedented overdose crisis and looming turmoil in the program.</p>","PeriodicalId":49810,"journal":{"name":"Milbank Quarterly","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143677332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medicaid Expansion Among Nonelderly Adults and Cardiovascular Disease: Efficiency Vs. Equity.","authors":"Luke E Barry, Sanjay Basu, May Wang, Roch A Nianogo","doi":"10.1111/1468-0009.70004","DOIUrl":"10.1111/1468-0009.70004","url":null,"abstract":"<p><p>Policy Points Evidence suggests Medicaid expansion has improved cardiovascular disease (CVD) outcomes, especially among those of lower socioeconomic status. However, less is known about the cost-effectiveness of Medicaid in achieving these outcomes and reducing CVD disparities. We found that Medicaid expansion resulted in a reduction in CVD incidence, suggesting that it was cost-effective in reducing CVD outcomes and equity enhancing but with a high degree of uncertainty. Policymakers will need to trade-off among a number of different factors in consideration of the value of Medicaid including health (especially in treating the chronically ill), financial protection, reduced uncompensated care, and health disparities.</p><p><strong>Context: </strong>Evidence suggests Medicaid expansion has improved cardiovascular disease (CVD) outcomes, especially among those of lower socioeconomic status. However, less is known about the cost-effectiveness of Medicaid in achieving these outcomes and reducing CVD disparities. We use distributional cost-effectiveness analysis methods to examine the efficiency and equitability of Medicaid expansion in reducing CVD outcomes.</p><p><strong>Methods: </strong>A Monte Carlo Markov-chain microsimulation model was developed to examine lifetime changes in CVD outcomes and disparities as a result of expansion and the associated cost and quality-of-life impacts.</p><p><strong>Findings: </strong>Medicaid expansion was associated with a reduction of 11 myocardial infarctions, eight strokes, and four CVD deaths per 100,000 person-years compared with no expansion. The largest reductions occurred for those with lower income and education, and those of Black and Hispanic race/ethnicity. We found that the benefits of expansion generally balanced out the costs while redistributing health from higher to lower income groups. In probabilistic sensitivity analysis, we found-using a health opportunity cost threshold of $150,000-that Medicaid expansion was cost-effective in reducing CVD outcomes 53% of the time and both cost-effective (efficient) and equity enhancing 26% to 29% of the time.</p><p><strong>Conclusions: </strong>Medicaid expansion resulted in a reduction in CVD incidence, suggesting that it was both cost-effective and equity enhancing in reducing CVD outcomes but with a high degree of uncertainty.</p>","PeriodicalId":49810,"journal":{"name":"Milbank Quarterly","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143671652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How Are You Doing… Really? A Review of Whole Person Health Assessments.","authors":"Stephanie B Gold, Allison Costello, Maura Gissen, Selin Odman, Larry A Green, Kurt C Stange, Réna Swann, Rebecca S Etz","doi":"10.1111/1468-0009.12727","DOIUrl":"10.1111/1468-0009.12727","url":null,"abstract":"&lt;p&gt;&lt;p&gt;Policy Points A redirection of measurement in health care from a narrow focus on diseases and care processes towards assessing whole person health, as perceived by the person themself, may provide a galvanizing view of how health care can best meet the needs of people and help patients feel heard, seen, and understood by their care team. This review identifies key tensions to navigate as well as four overarching categories of whole person health for consideration in developing an instrument optimized for clinical practice. The categories (body and mind, relationships, living environment and finances, and engagement in daily life) include nine constituent domains. To maximize value and avoid unintended consequences of implementing a new measure, it is essential to ensure adequate time with the person providing the responses. Use of the instrument should be framed around the goal of better understanding a person's whole health and strengthening their relationship with the care team and not for comparisons across physicians or meeting a target score.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Context: &lt;/strong&gt;Frustration with the burden of proliferating measures in health care focused on diseases and care processes has added to the growing desire to measure what matters to people, including understanding how people are doing in terms of their whole health. There is no consensus in the literature on an ideal whole person health instrument for use in practice. To provide a foundation for assessing whole person health and support further instrument development, this review summarizes past work on assessing person-reported whole health, articulates conceptual domains encompassing whole health, and identifies lessons from existing instruments, including considerations for administration.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A scoping literature review and instrument review were conducted. Concepts from the literature and instruments were thematically coded using a grounded theory approach.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Findings: &lt;/strong&gt;We identified four overarching categories of whole person health, consisting of nine domains: body and mind (physical well-being, mental/emotional well-being, meaning and purpose [spiritual well-being], sexual well-being), relationships (social well-being), living environment and finances (financial well-being, environmental well-being), and engagement in daily life (autonomy and functioning, activities). A tenth domain of global well-being was used for instruments that assessed well-being as a whole. In total, 281 instruments were examined; most were specific to a single domain or subdomain. Fifty instruments assessed at least three domains; only five assessed all domains identified. Two key tensions must be navigated in the development of a whole person health instrument: comprehensiveness versus brevity, and standardization versus flexibility.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The array of whole person health domains identified in this review and lack of con","PeriodicalId":49810,"journal":{"name":"Milbank Quarterly","volume":" ","pages":"205-241"},"PeriodicalIF":4.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11923716/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142957847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Centering Equity in Evidence-Informed Decision Making: Theoretical and Practical Considerations.","authors":"Bomi Kim Hirsch, Kiersten Frobom, Gillian Giglierano, Michael C Stevenson, Marjory L Givens","doi":"10.1111/1468-0009.70002","DOIUrl":"10.1111/1468-0009.70002","url":null,"abstract":"<p><p>Policy Points The population health research field should develop a synthesized approach to evaluate evidence for an intervention's potential impact on equity. When empirical evidence is lacking, theory and frameworks should guide the equity assessments in four areas: 1) understanding historical context, meaning root causes of disparities and inequity; 2) understanding intervention design and intended beneficiaries; 3) understanding differential impact and intersectionality; and 4) understanding community context before implementing or scaling interventions. The synthesized approach of equity assessment better informs practitioners and policymakers in evidence-based decision making to advance equity.</p>","PeriodicalId":49810,"journal":{"name":"Milbank Quarterly","volume":" ","pages":"11-31"},"PeriodicalIF":4.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11923710/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143525109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mental Health Treatment Access: Experience, Hypotheticals, and Public Opinion.","authors":"Jake Haselswerdt","doi":"10.1111/1468-0009.12726","DOIUrl":"10.1111/1468-0009.12726","url":null,"abstract":"<p><p>Policy Points Policymakers should consider both material (e.g., cost) and attitudinal (e.g., skepticism) barriers to mental health treatment access. Public support for government action on mental health is high but varies based on experience-based and hypothetical beliefs about barriers to treatment. Appeals to personal experience and perspective-taking may be successful in building support for government action on mental health.</p><p><strong>Context: </strong>Mental health problems represent a major public health issue for the United States, and access to mental health treatment is both inadequate and unevenly distributed. There is a strong justification for government action on mental health treatment, but it is unclear whether there is a political constituency for such action. Existing work suggests that stigma and othering of people with mental illnesses contributes to reduced support for intervention. I expand on the existing literature by focusing on mental health as an issue that may apply to Americans' own lives rather than only to a stigmatized outgroup.</p><p><strong>Methods: </strong>Using original questions on a nationally representative 2023 survey of 1,000 American adults, I measured agreement with statements about barriers to mental health treatment access that respondents have experienced or, if they have not sought treatment, their hypothetical assessment of these barriers. I also measured their support for statements in favor of change to address mental health. I analyzed the demographic and political correlates of agreement with the barrier statements and used regressions to examine their possible causal effect on support for change.</p><p><strong>Findings: </strong>Agreement with statements about access barriers follows expected patterns in some cases (e.g., socioeconomic status) but not in others (e.g., race/ethnicity). I also documented a notable partisan and ideological divide in these experiences and beliefs. I found that Americans who agreed that material factors are a barrier to access were more supportive of action on mental health, whereas those who agreed with statements suggesting discomfort or skepticism were less supportive.</p><p><strong>Conclusions: </strong>These findings suggest that personal experience and perspective-taking should be integrated into the study of public opinion on mental health, complementing existing work on stigma and othering. Appeals to experience and perspective-taking may be a successful strategy for building public support for action on mental health.</p>","PeriodicalId":49810,"journal":{"name":"Milbank Quarterly","volume":" ","pages":"100-129"},"PeriodicalIF":4.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11923704/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}