Inquiry-The Journal of Health Care Organization Provision and Financing最新文献

{"title":"Understanding Factors Influencing Geographic Variation in Healthcare Expenditures: A Small Areas Analysis Study.","authors":"Peiya Cao, Jay Pan","doi":"10.1177/00469580231224823","DOIUrl":"10.1177/00469580231224823","url":null,"abstract":"<p><p>Dramatic geographic variations in healthcare expenditures were documented by developed countries, but little is known about such variations under China's context, and what causes such variations. This study aims to examine variations of healthcare expenditures among small areas and to determine the associations between demand-, supply-factors, and per capita inpatient expenditures. This cross-sectional study utilized hospital discharge data aggregated within delineated hospital service areas (HSAs) using the small-area analysis approach. Linear multivariate regression modeling with robust standard errors was used to estimate the sources of variation of per capita inpatient expenditures across HSAs covering the years 2017 to 2019; the Shapley value decomposition method was used to measure the respective contributions of demand-, supply-side to such variations. Among 149 HSAs, demand factors explained most of the (87.4%) overall geographic variation among HSAs. With each 1% increase in GDP per capita and urbanization rate was associated with 0.099% and 0.9% increase in inpatient expenditure per capita, respectively, while each 1% increase in the share of females and the unemployment rate was associated with a 0.7% and 0.4% reduction in the per capita inpatient expenditures, respectively. In supply-side, for every 1 increase in hospital beds per 1000 population, the per capita inpatient expenditures rose by 2.9%, while with every 1% increase in the share of private hospitals, the per capita inpatient expenditures would decrease by 0.4%. With Herfindahl-Hirschman Index decrease 10%, the per capita inpatient expenditures would increase 1.06%. This study suggests demand-side factors are associated with large geographic variation in per capita inpatient expenditures among HSAs, while supply-side factors played an important role. The evaluation of geographic variations in per capita inpatient expenditures as well as its associated factors have great potential to provide an indirect approach to identify possibly existing underutilized or overutilized healthcare procedures.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10823849/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139572084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Price Transparency in United States' Health Care: A Narrative Policy Review of the Current State and Way Forward.","authors":"David N Bernstein, Jonathan R Crowe","doi":"10.1177/00469580241255823","DOIUrl":"10.1177/00469580241255823","url":null,"abstract":"<p><p>Health care price transparency is gaining momentum as a tangible policy intervention that can unleash market principles to increase competition, help begin to decrease U.S. health care expenditures, and provide Americans with access to affordable, high-quality health care. Indeed, pricing reform is required to facilitate patient shopping in health care. In this narrative policy review, we offer a brief history of health care price transparency efforts and an overview of the health care price transparency literature. Further, we highlight the current rules and legislative initiatives aimed at achieving the full potential of health care price transparency. Lastly, we offer key takeaways and highlight suggestions for future policy directions, including the need to ensure hospital and insurance compliance through more appropriate penalties and incentives, importance of reducing regulation to promote financial upside that can be obtained by both patients and providers who actively promote shopping for lower cost, higher quality health care goods and services, and the need for transparent and easily found quality metrics, including outcomes most important to patients, driven by physicians \"on the ground\" with patient input.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11129567/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141155443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"The Simpler, the Better.\" A Qualitative Study on Digital Health Transformation in Early Adopter Rheumatology Outpatient Clinics.","authors":"Susann May, Robert Darkow, Johannes Knitza, Katharina Boy, Julian Schwarz, Martin Heinze, Johannes Hornig, Peer Aries, Martin Welcker, Felix Muehlensiepen","doi":"10.1177/00469580241247021","DOIUrl":"10.1177/00469580241247021","url":null,"abstract":"<p><p>Workforce shortage and the increasing burden of rheumatic and musculoskeletal diseases lead to extreme time constraints in rheumatology outpatient care. Digital services promise to facilitate care by relieving employees and unleash new capacities. This study aims to explore the perspectives of early adopter health care professionals (HCP) on digital transformation in outpatient rheumatology. In-depth qualitative interviews were conducted with rheumatology nurses and physicians in 3 German rheumatology outpatient clinics, each characterized by an advanced level of digital adaption. Qualitative data were subsequently analyzed using deductive-inductive qualitative content analysis. Interviews with 11 rheumatology nurses and 5 rheumatologists were completed. Three key themes emerged from the qualitative analysis: (i) Digital transformation of care; (ii) impact of digital transformation on health care delivery; and (iii) perceived drivers of successful digitalization. The interviews revealed that digital technologies are widely used throughout the complete patient pathway. Digitalization enables more continuity and flexibility in rheumatology care. Patient information can be electronically obtained in a standardized manner prior to planned visits, enabling an informed consultation and more time for in-depth patient discussion. Although digitalization restructures work, it can also increase the current workload. Improved accessibility for patient calls leads to more work for HCP. Important drivers of successful digital technology implementation are low-threshold and interoperable services, a medical team that is interested and educated in eHealth, and comprehensive patient information and onboarding. Digital transformation is increasingly redefining rheumatology care. While accelerating communication and workflows, improved service accessibility leads to more work for HCP.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11131398/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141155393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Frailty and its Associated Factors Among Rural Community-Dwelling Older Adults: A Cross-Sectional Study.","authors":"Shaobo Guo, Hongxia Liu, Bei Zhang, Xiangru Li, Keke Lin","doi":"10.1177/00469580241273120","DOIUrl":"10.1177/00469580241273120","url":null,"abstract":"<p><p>To investigate the status quo and influencing factors of overall frailty and its 3 domains among rural community-dwelling older adults. This is a cross-sectional study. A convenience sample of 195 older adults from 6 villages in Bashang Area of Zhangjiakou City, Hebei Province, China, were recruited from August to September, 2022. The demographic characteristics, the Chinese version of Tilburg Frailty Indicator, Charlson Comorbidity Scale and Hospital Anxiety and Depression Scale were used to investigate frailty and its influencing factors. Univariate analysis and multiple linear regression analysis were employed. The prevalence of overall frailty among the older adults in Bashang Area was 85.13%. Multiple linear regression analysis showed that age, gender, marital status, regular exercise, comorbidity, and anxiety were the influencing factors of overall frailty. While anxiety was the only shared influencing factor for physical frailty, psychological frailty, and social frailty, age, gender, marital status, financial burden, the comorbidity, and regular exercise were factors which influenced 1 or 2 domains of frailty. The prevalence of overall frailty among the older adults in rural areas, Zhangjiakou City is high. It is influenced by many factors. Medical staff and policy makers should work hand in hand to improve frailty among rural community-dwelling older adults in China.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11348363/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142057389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex- and Age-Specific Associations Between Metabolic Syndrome and Future Functional Disability in the Japanese Older Population.","authors":"Naomi Takahashi, Megumi Tsubota-Utsugi, Shuko Takahashi, Yuki Yonekura, Masaki Ohsawa, Toru Kuribayashi, Toshiyuki Onoda, Nobuyuki Takanashi, Kiyomi Sakata, Takehiko Yamada, Kuniaki Ogasawara, Shinichi Omama, Fumitaka Tanaka, Koichi Asahi, Yasushi Ishigaki, Ryo Itabashi, Hiroaki Itamochi, Fumiaki Takahashi, Akira Okayama, Kozo Tanno","doi":"10.1177/00469580241273103","DOIUrl":"10.1177/00469580241273103","url":null,"abstract":"<p><p>Whether the association between metabolic syndrome (MetS) and functional disability differs depending on sex or age remains unknown. To determine the association between MetS and functional disability in older people separately by sex and age groups. A total of 11 083 participants (4407 men and 6676 women) aged 65 years or over without functional disability were enrolled. MetS was defined according to the revised NCEP ATP III guidelines. Functional disability was defined by a new certification in the long-term care insurance in Japan. Cox proportional hazards models were used to assess the risk of functional disability with adjustment for possible confounding factors. Over the mean observation period of 10.5 years, 1282 men and 2162 women experienced functional disability. For those aged 65 to 74 years, HRs (95% CIs) for functional disability in the MetS group were 1.33 (1.07-1.66) in men and 1.15 (1.000-1.32) in women. For those aged 75 years or older, there was no significant association in men or women. In subjects with a severe care need level, there was a marginal significant association in men aged 65 to 74 years. Among the MetS components that independently increased the risk of functional disability were glucose intolerance and elevated blood pressure (men and women aged 65-74 years), obesity (women aged 65-74 years), and glucose intolerance (women aged 75 years or older). MetS contributed to an increase in a high risk of future functional disability among individuals aged 65 to 74 years. In this age group, improvement of lifestyle, health promotion and interventions for MetS from middle age may prevent future functional disability.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11348345/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142057392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Equity in Digital Health: Assessing Access and Utilization of Remote Patient Monitoring, Medical Apps, and Wearables in Underserved Communities.","authors":"Omolola Adepoju, Patrick Dang, Holly Nguyen, Jennifer Mertz","doi":"10.1177/00469580241271137","DOIUrl":"https://doi.org/10.1177/00469580241271137","url":null,"abstract":"<p><p>This study examined access to, and use of remote patient monitoring (RPM), medical applications, and wearables in a racially diverse, lower-income population. Data were obtained via a cross-sectional survey of adults from low-income communities in Houston, Los Angeles, and New York between April and August 2023. The survey examined access to, and use of RPM, medical applications, and wearables, among respondents. Binary responses to the following questions were examined using logistic regression models: In the past 12 months, have you (i) used RPM, (ii) used a medical app, and (iii) used an electronic wearable device to monitor or track health or activity? A total of 305 surveys were returned, of which 212 were complete (69.5% completion rate). Demographically, 22% self-identified as Hispanic, 41% as non-Hispanic Black individuals, and 33% as non-Hispanic White individuals. Overall, 69% of respondents reported a pre-tax annual household income of less than $35 000 and 96% indicated they own a smart phone. However, only 3 of 10 reported using RPM, 15% reported using a medical app, and 14% reported using wearables. Race was strongly associated with RPM usage, with Black respondents significantly less likely to have used RPM, compared to their white counterparts (OR: 0.31, <i>P</i> = .002). Education (bachelor's degree or more OR: 4.79, <i>P</i> = .03) and higher income ($35 001 + OR: 4.68, <i>P</i> = .008) were strongly associated with medical app usage. In the wearables model, the same trend was observed with education (bachelor's degree or more OR: 4.45, <i>P</i> = .04), and higher income ($35 001 + OR: 5.49, <i>P</i> = .01). Compared to earlier studies that have reported utilization rates of between 50% and 60%, our finding of much lower utilization in economically disadvantaged populations that are at greater risks for sub-optimal health outcomes gives cause for greater concern. Considering the ongoing proliferation of digital health technological modalities, this further highlights the need to explore and address equity-based barriers to these health tools.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142332688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Racial and Ethnic Disparities in Preventive Service Use Among Adults Before and During the COVID-19 Pandemic.","authors":"Lisa Dubay, Fredric E Blavin, Laura Barrie Smith, Julianna Carlyn Long","doi":"10.1177/00469580241275319","DOIUrl":"10.1177/00469580241275319","url":null,"abstract":"<p><p>Our objective was to assess changes in preventive services use before and during the COVID-19 pandemic. We obtained secondary survey data from the National Health Interview Survey for 2019 and 2021. We examined, six preventive services among all adults. Descriptive and multivariate analyses assessed changes in preventive service use among adults and by race/ethnicity for 2019 and 2021 (drawing from an unweighted sample of 60 843 weighted to be 386.2 million across both years). We used Ordinary least squares estimation to conduct a difference-in-differences analysis that assessed changes in service use for non-white racial/ethnic groups relative to changes for white non-Hispanic adults between 2019 and 2021. We found preventive services use declined overall for each screening service assessed. Asian adults experienced the largest declines relative to white adults for \"well visit within the last year\" (-7.45 percentage points (pp) relative to white adults), \"blood pressure screening within the last year\" (-7.85 pp), and \"mammograms within the last year\" (-12.3 pp). While adults in other racial/ethnic groups did not experience significant declines in preventive services use relative to white adults between 2019 and 2021, pre-existing disparities remained for Hispanic and American Indian/Alaska Native (AIAN) adults compared to white adults. In conclusion, preventive service use declined in the first years of the COVID-19 public health emergency, and existing disparities in access for Hispanic and AIAN adults continued. Future research should investigate barriers Asian adults may face in obtaining access to preventive services after the conclusion of the public health emergency and federal pandemic-related protections.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11418443/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142301365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identifying Provider Barriers to the Implementation of Opioid Harm Reduction Methods: An Initial Narrative Review.","authors":"Stacie A Dee, Ketrice-Ann Delonnay, Destiny Bernard, Fahimir Jean-Baptiste","doi":"10.1177/00469580241276144","DOIUrl":"10.1177/00469580241276144","url":null,"abstract":"<p><p>According to the Centers for Disease Control and Prevention, the opioid epidemic remains a major issue in the United States, with over 80,000 deaths attributed to opioids in 2021. This public health crisis continues to impact communities across the country, highlighting the need for intervention and reflecting the nation's failed attempts at prohibition through criminalization to reduce opioid use. Harm reduction methodshave proven to be effective in preventing adverse health outcomes and promoting the overall well-being of individuals with opioid use disorders. However, significant gaps remain in the universal implementation by healthcare providers. This review evaluated the PICOT question: What barriers exist among providers in implementing evidence-based harm reduction methods for adults aged 18 years and older, with and without opioid use disorders? A literature search was conducted across databases using key words which included: \"Health care provider,\" \"Physician,\" \"Pharmacist,\" \"Harm reduction,\" \"Harm reduction programs,\" \"Naloxone,\" \"Buprenorphine-naloxone induction,\" \"Methadone,\" \"Naloxone take home kits,\" \"Stigma,\" \"Barriers,\" \"Negative perception,\" \"Refusal.\" The inclusion criteria focused on identifying provider barriers, specifically regarding opioid use. . The review revealed 3 major barriers that exist among providers to prevent harm reduction: stigma, lack of education and knowledge, and lack of access to resources for long-term management. Recognizing these barriers among providers can help organizations develop targeted interventions to overcome them, leading to widespread adoption of opioid harm reduction methods. The results provide an initial narrative review of the current evidence at the time of the authors search to inform practice, policy, and future research.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11423376/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142309160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Market Factors Associated with Comprehensive Behavioral Health Crisis Care Availability: A Resource Dependence Theory Study.","authors":"Ashlyn Burns, Joshua R Vest, Nir Menachemi, Olena Mazurenko, Michelle P Salyers, Valerie A Yeager","doi":"10.1177/00469580241256822","DOIUrl":"10.1177/00469580241256822","url":null,"abstract":"<p><p>Behavioral health crisis care (BHCC) is a care delivery model for individuals experiencing acute distress related to a mental health or substance use disorder. We examined market factors associated with comprehensive BHCC availability using 2022 data on mental health treatment facilities (n = 9385) obtained from the Substance Abuse and Mental Health Services Administration. We aggregated facility-level data by county (n = 3142) and merged with county-level market factors. Logistic regression models were used to examine the adjusted associations between market factors and BHCC availability. We found that 468 (14.9%) counties had at least one mental health treatment facility offering comprehensive BHCC services. Specifically, counties with more mental health providers (Adjusted Odds Ratio = 2.26, Confidence Interval = 1.32-3.86) and metropolitan counties (AOR = 3.26, CI = 1.95-5.43) had higher odds of having a comprehensive BHCC facility. Our findings highlight the importance of developing the mental health workforce to increase BHCC availability and a need to address disparities in rural counties.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11159547/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141263274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incentives and Operations of Medicaid Managed Care Plans in New York State: Implications for Procurement Design and Market Evolution.","authors":"Naomi Zewde, Victoria Perez","doi":"10.1177/00469580241258653","DOIUrl":"10.1177/00469580241258653","url":null,"abstract":"<p><p>Several states are considering competitive procurement to help shape Medicaid managed care markets. In New York state, the focus of our study, regulators propose contracts that reward quality improvement and simplify state administration by rewarding plans that operate across several of the state's 62 counties. This case analysis uses novel regulatory data from New York state, obtained via public records request, to examine incentives underlying Medicaid markets and help inform contracting design. The data report plan enrollment by county and plan spending across administrative activities for all 16 Medicaid plans in New York state for 2018. We examine the counties in which plans operate, profitability, and administrative resource allocation. We compare outcomes by tertile of plan profitability, measured as net income per member-month. Plan profitability ranged widely, with the most profitable plan realizing nearly $30 per member-month while the least profitable 5 plans realized net negative earnings. Operational differences across plan profitability emerged most clearly in administrative spending. The most profitable plans reported greater spending on salaries overall and for executive management, and taxes, while the least profitable plans spent more on operational functions including utilization management/ quality improvement, claims processing, and informational systems. We observe modest differences in county rurality and little in geographic breadth. Procurement design that rewards capacity-building in key administrative functions might impact market evolution, given that on average, highly profitable firms spent less on these activities in New York's Medicaid managed care market in 2018.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11265242/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141443778","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}