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

{"title":"Integrating Kidney Health into Universal Health Coverage Beyond Dialysis: Lessons from Thailand for Southeast Asia.","authors":"Nam T Nguyen, Mateen Abbasi, Arnav Ajay Jadav, Perisa Ashar, Emaad Khan, Ketan Tamirisa, Sammer Marzouk, Faraan Rahim","doi":"10.1177/00469580261501006","DOIUrl":"https://doi.org/10.1177/00469580261501006","url":null,"abstract":"<p><p>PurposeChronic kidney disease (CKD) represents a growing health and equity challenge in Southeast Asia; however, kidney care remains insufficiently integrated into universal health coverage (UHC). This policy brief examines how countries in Southeast Asia can translate growing policy recognition of kidney health into financed and measurable healthcare system action, drawing primarily on Thailand's experience.Policy ContextWHO Resolution WHA78.6 has recognized kidney disease as an NCD priority requiring prevention, management, and surveillance at the national level. In Southeast Asia, its implementation faces existing barriers, including late diagnosis, high treatment costs, and a shortage of nephrologists. Thailand's experience illustrates the potential role of UHC benefit packages for dialysis provision in the region, as well as the need to align dialysis coverage with service capacity and to invest in earlier care that prevents progression to kidney failure.Policy RecommendationsHealth ministries and other partners should prioritize four actions. First, develop a minimum package for kidney health that will strengthen early detection and effective treatment. Second, integrate stronger CKD screening, treatment, and follow-ups into routine diabetes and hypertension services. Third, expand the non-specialist workforce (i.e., task-sharing, standardized protocols, and specialist support). Finally, improve the routine surveillance of CKD burden, access, and outcomes.ConclusionsKidney health should be treated as an integral component of UHC rather than limited to dialysis coverage. Sustainable progress may require coordinated investments in primary care, workforce capacity, financing, specialist support, and measurable accountability.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":"63 ","pages":"469580261501006"},"PeriodicalIF":3.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149217279","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":"Self-Rated Health Trajectories Among Adults Aged 51-64 Years at Baseline: A 10-Year Group-Based Trajectory Analysis Informed by Roy's Adaptation Model.","authors":"Hyuk Joon Kim, Hye Young Kim, Jihyun Baek, No Eul Kang","doi":"10.1177/00469580261497782","DOIUrl":"https://doi.org/10.1177/00469580261497782","url":null,"abstract":"<p><p>IntroductionUsing Roy's Adaptation Model, this study identified self-rated health (SRH) trajectories among late middle-aged adults and examined baseline (Wave 5) factors associated with trajectory-group membership.MethodsThis secondary analysis used Korean Longitudinal Study of Aging waves 5-10 (2014-2024). Group-based trajectory modeling was applied to 2,680 adults aged 51-64 years with at least three valid SRH responses; 428 participants lacking a valid integrated longitudinal weight (for complex-samples analyses) were excluded, yielding a final subsample of 2,252 for multinomial logistic regression incorporating sampling weights and the complex survey design.ResultsThree SRH trajectories emerged: low-health (7.3%), moderate-health (48.8%), and high-health (43.9%). Compared with the low-health group (reference), high-health group had lower hypertension, diabetes, and arthritis prevalence, and more favorable contextual stimuli (older age, lower odds; higher education, higher odds). Among adaptation-related factors, high-health group was positively associated with regular exercise (OR=2.13, 95% CI 1.26-3.60, ref: no exercise), higher life satisfaction (OR=1.04, 95% CI 1.02-1.06), economic activity (OR=2.03, 95% CI 1.23-3.35, ref: inactive), and social participation (OR=2.37, 95% CI 1.62-3.46), and negatively with depression (OR=0.86, 95% CI 0.75-0.99). Current drinking (OR=1.90, 95% CI 1.18-3.05, ref: non-drinker) and overweight status (OR=1.79, 95% CI 1.03-3.11, ref: normal weight) were unexpectedly and positively associated with this trajectory, an observational finding warranting caution.ConclusionThese cross-sectional associations align with the physiologic, self-concept, role function, and interdependence modes described by Roy's Adaptation Model, but interactions, mediation, and causal mechanisms were not tested.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":"63 ","pages":"469580261497782"},"PeriodicalIF":3.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149217298","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":"Reconfiguring Care Practices Through Technology-Supported Services: Pathways to Outpatient Satisfaction in Urban and Rural Public Hospitals.","authors":"Ferry Fadzlul Rahman, Herni Johan, Jovi Sulistiawan","doi":"10.1177/00469580261453881","DOIUrl":"10.1177/00469580261453881","url":null,"abstract":"<p><p>IntroductionThis study examines how technology-supported services contribute to the reconfiguration of care practices and how these processes shape pathways to outpatient satisfaction in public hospitals. Rather than treating digital technologies as standalone solutions, this study analyzes the pathways linking structural conditions, care processes, and technology-supported services to outpatient satisfaction, with particular attention to differences between urban and rural public hospitals.MethodsA cross-sectional survey was conducted among 2,084 outpatients attending five public hospitals (two city-level and three rural-level) in East Kalimantan, Indonesia. Patient-reported experiences of care were analyzed using an extended structure-process-outcome framework. In this framework, technology-supported services were incorporated as a process-related component. Partial Least Squares Structural Equation Modeling (PLS-SEM) was used to estimate direct and indirect pathways to general patient satisfaction, with subgroup analyses for urban and rural hospitals.ResultsCare processes, particularly caring attitudes and emotional support, were central determinants of outpatient satisfaction across settings. Structural factors showed both direct and mediated effects, with professional competence more influential in urban hospitals and environment and facilities more salient in rural hospitals. Technology-supported services had a significant direct effect on satisfaction and mediated the relationship between structural capacity and patient experiences, though their relative importance varied by context.ConclusionBy conceptualizing technology-supported services as embedded care practices rather than standalone tools, this study provides new evidence on the pathways linking care practices to outpatient satisfaction in public hospitals.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":"63 ","pages":"469580261453881"},"PeriodicalIF":3.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13260970/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148229248","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":"Channeling Patient Flow in China: An Agent-Based Model of Insurance Reimbursement and Hierarchical Care.","authors":"Ning Zhao, Jia Yang, Mei Gu, Jin Li, Danhui Li, Wensheng Ju, Moning Guo","doi":"10.1177/00469580261422679","DOIUrl":"10.1177/00469580261422679","url":null,"abstract":"<p><p>In China, the absence of a strict referral system leads to overcrowding in tertiary hospitals and underutilization of primary care, challenging the implementation of a tiered diagnosis and treatment system. This study investigates how differential health insurance reimbursement rates can be leveraged to guide patient flow. We developed an agent-based simulation model, calibrated with real-world data on hypertensive inpatients from Beijing (2015-2017). The model simulated patient healthcare-seeking choices under various reimbursement scenarios for primary, secondary, and tertiary hospitals. Adjusting reimbursement rates significantly redirected patient flow and altered medical insurance fund expenditure. Increasing the reimbursement rate for primary hospitals proved particularly effective in channeling patients toward them. We identified an optimal balance-maximizing the proportion of hypertensive inpatients seeking care at primary hospitals (achieving 36.41%, compared to an observed baseline of 16.39%) while controlling total fund expenditure-when reimbursement rates were set at 95% for primary, 85% for secondary, and 70% for tertiary hospitals. Differential health insurance reimbursement serves as a potent policy lever to steer patient flow within a tiered healthcare system. The agent-based modeling approach provides a valuable tool for policymakers to simulate and identify optimal reimbursement strategies, thereby promoting efficient healthcare delivery and sustainable fund management.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":"63 ","pages":"469580261422679"},"PeriodicalIF":3.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12979921/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147437870","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":"Work-Life Conditions as the Primary Determinant of Seafarer Mental Health: An Explainable Machine Learning Analysis.","authors":"Yongwei Jiang, Zhendong Tang, Hua Liu, Wenjie Cao, Zhiwei Zhao, Özkan Uğurlu, Xinjian Wang","doi":"10.1177/00469580261438708","DOIUrl":"10.1177/00469580261438708","url":null,"abstract":"<p><p>Seafarer mental health has become an increasingly critical concern due to its substantial implications for transportation safety and operational performance. Traditional analytical approaches often inadequately capture the complex, non-linear interactions among the multidimensional determinants involved. To bridge this gap, this study proposes an explainable machine learning (ML) framework that integrates a Random Forest classifier with SHapley Additive exPlanations (SHAP) for simultaneous prediction and interpretation. Based on a survey of 500 seafarers, 12 risk factors were preprocessed through label encoding and the dataset was split into training and test sets using stratified sampling. A Random Forest model, optimized via Bayesian hyperparameter tuning, was employed to predict psychological states, with performance evaluated through accuracy, precision, recall, and F1-score. SHAP analysis was then applied to quantify global feature importance and to examine individual prediction mechanisms and interaction effects. The results identify current work-life conditions as the most influential determinant, exhibiting a polarizing effect on psychological states that substantially outweighs other factors. Furthermore, favorable environmental conditions amplify the positive effects of career development and social recognition, whereas high onboard service pressure persistently undermines mental health even under otherwise optimal circumstances. These findings underscore the necessity of prioritizing systemic environmental improvements as a foundation for effective psychological interventions, suggesting that tailored support strategies should be implemented subsequent to such enhancements. This study provides a data-driven, interpretable framework to support precision mental health management in maritime operations. These findings advocate for maritime policymakers and shipping companies to prioritize systemic improvements in onboard living and working conditions as a foundational strategy, complemented by targeted psychological support and enhanced awareness of mental health services.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":"63 ","pages":"469580261438708"},"PeriodicalIF":3.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13080192/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147678752","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":"Prevalence and Contributing Factors of Depression Among the Older Adults in Sundarharaincha Municipality of Eastern Nepal.","authors":"Pratima Niraula, Binita Kumari Paudel, Rahi Bikram Thapa, Lok Raj Bhatt, Prakash Pathak","doi":"10.1177/00469580261452188","DOIUrl":"10.1177/00469580261452188","url":null,"abstract":"<p><p>IntroductionThe world's older adult population is rising rapidly, leading to an increase in mental health problems such as geriatric depression, which has mainly been studied in high-income countries. Similar studies are scarce in low- and middle-income countries like Nepal. So, this study aims to determine the prevalence of depression and its predictors among the older adults living in Sundarharainha Municipality, Morang.MethodsA cross-sectional, community-based study was conducted using the Validated Nepali version of the Geriatric Depression Scale short form (GDS-15) to identify geriatric depression among the older adults (≥60 years). Those scoring >5 on GDS-15 were considered depressed. Logistic Regression Analysis explored the associations of geriatric depression with potential predictor variables.ResultsOf the 417 selected older adult participants, more than half were males (52.0%), the majority were illiterate (57.6%), and approximately two-thirds were married (66.7%). The prevalence of geriatric depression was found to be 62.4%. Geriatric depression was significantly associated with gender, marital status, level of education, occupation status, limited time provided by families, chronic physical health problems, and exposure to verbal and/or physical abuse. In logistic regression analysis, geriatric depression was significantly associated with educational status (AOR 3.25), family types (AOR 3.75), perceived respect from family (AOR 2.05), financial support (AOR 2.01), sleep quality (AOR 3.26), and seeking professional help (AOR 1.80).ConclusionGeriatric depression is highly prevalent in Sundarharaicha Municipality, Nepal. The findings call for the urgent prioritization of the delivery of mental health care services to older adults in the country.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":"63 ","pages":"469580261452188"},"PeriodicalIF":3.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13260977/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148229090","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":"Access Barriers to Healthcare and Full Childhood Immunization Coverage in East Africa (2015-2023): A Propensity Score Matched Analysis.","authors":"Endalkachew Dellie, Chalie Tadie Tsehay, Getachew Teshale, Andualem Yalew Aschalew, Asebe Hagos, Tesfahun Zemene Tafere, Nebebe Demis Baykemagn, Nigusu Worku","doi":"10.1177/00469580261441758","DOIUrl":"10.1177/00469580261441758","url":null,"abstract":"<p><p>Barriers to accessing healthcare are significant obstacles to achieving full immunization coverage, yet their impact remains underexplored in existing literature. Therefore, we assessed the effect of barriers to accessing healthcare on full immunization coverage in East African countries. This study used a cross-sectional design, using pooled demographic and health survey data (2015-2023) from 11 East African countries. After removing observations with missing data, the final weighted sample included 48 351 children aged 12 to 35 months, all born within 5 years of each country's survey period. The outcome variable was full immunization coverage, whereas the treatment variable was barriers to accessing healthcare. We used propensity score-matching to estimate the average treatment effect of barriers to healthcare access on vaccination coverage, comparing children who faced these barriers (treated) with those who did not (untreated). Approximately two-thirds of children aged 12 to 35 months in East Africa (65.5%; 95% CI: 65.1-65.9) were from mothers who reported at least 1 barrier to accessing healthcare. The average treatment effect on the treated (ATT) estimate revealed that facing at least 1 barrier to accessing healthcare reduced the probability of completing the recommended vaccination by 3.8 percentage points (ATT = -0.038, 95% CI: -0.063, -0.014). Among the assessed barriers, challenges obtaining permission to visit health facilities, lack of companionship when seeking care, distance to the health facility, and difficulty obtaining money for treatment reduced full vaccination coverage by 12.1, 10.2, 8.2, and 2.2 percentage points, respectively. This study revealed that barriers to accessing healthcare, including geographical inaccessibility, lack of companionship, financial constraints, and the need for permission to seek care, negatively affect childhood vaccination coverage. Therefore, our findings underscore the need for public health interventions that address these barriers to enhance childhood vaccination coverage.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":"63 ","pages":"469580261441758"},"PeriodicalIF":3.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13080196/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147678866","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":"Association Between Daily Convenience Store Use and Social Capital Among Young People in Japan: An Exploratory Secondary Analysis of Cross-Sectional Study Data.","authors":"Aya Goto, Gavin H Whitelaw, Takahiro Tabuchi","doi":"10.1177/00469580261422663","DOIUrl":"10.1177/00469580261422663","url":null,"abstract":"<p><p>The number of convenience stores in Japan has increased dramatically since their introduction in the 1970s, offering a wide range of essential services. However, epidemiological research on their use and public health impacts remains limited. This study aimed to explore the characteristics of frequent convenience store users and the association between daily use and social capital, measured as general trust in one's neighbors and trust in mutual help/reciprocity among them. This was a secondary analysis of the 2025 Japan Society and New Tobacco Internet Survey (JASTIS 2025)-a cross-sectional, web-based survey. The total number of respondents included in the analyses was 21 282. Convenience stores were used more frequently than supermarkets, with 8.1% reporting daily use, compared with 5.2% for supermarkets. Daily users were more likely to be men, younger, unmarried, living alone, and to have higher but unstable income and multiple health comorbidities. Among teenagers and young adults, daily convenience store use was significantly associated with higher social capital (aOR 2.18 [95% CI 1.14-4.15] for general social trust; aOR 1.88 [95% CI 1.02-3.44] for mutual help/reciprocity), while no such association was observed for supermarket use. Among teenagers and young adults, daily convenience store use was associated with higher social capital, while no such association was observed in older age groups or for supermarket use. These findings suggest that convenience stores may serve different social functions across age groups and warrant further investigation into underlying mechanisms.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":"63 ","pages":"469580261422663"},"PeriodicalIF":3.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13010040/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147505514","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":"Social Determinants of Health and Quality of Sexual Life Among Married Women in Behshahr, Iran, in 2023: A Cross-Sectional Study.","authors":"Farangis Habibi, Soghra Khani, Hoseinnataj Abolfazl, Razieh Afra","doi":"10.1177/00469580251411402","DOIUrl":"10.1177/00469580251411402","url":null,"abstract":"<p><p>Sexual health is a multidimensional aspect of women's well-being, yet its intersection with social determinants of health (SDH) remains critically underexplored in culturally conservative settings. In such contexts, sociocultural norms often obscure open discourse and research on sexual quality of life (QoSL), despite its central role in marital satisfaction and overall health. This study addresses this gap by examining the relationship between SDH and QoSL among married women in Behshahr, Iran. This study aimed to examine the associations between key social determinants of health and sexual quality of life, marital satisfaction, and perceived social support among married women of reproductive age in Behshahr, Iran. A descriptive cross-sectional study was conducted in 2023 among 380 married women aged 16 to 52 years, recruited through stratified random sampling from 6 healthcare centers in Behshahr, Iran. Data collection instruments included: Sociodemographic Form (SDF), Sexual Quality of Life-Female (SQOL-F) questionnaire, ENRICH Marital Satisfaction (EMS) scale, Multidimensional Scale of Perceived Social Support (MSPSS), Statistical analyses were performed using SPSS v26 and AMOS v26. Descriptive statistics (mean, SD, frequency) summarized the data. Inferential analyses included Pearson correlation, multiple linear regression (MLR), and confirmatory factor analysis (CFA). A significance level of <i>P</i> ≤ .05 was applied. The mean age of participants was 33.08 ± 5.31 years. The average scores were: QoSL = 90.92 ± 13.08, marital satisfaction = 162.16 ± 25.05, and perceived social support = 48.63 ± 11.62. A statistically significant but weak positive correlation was found between QoSL and marital satisfaction (<i>r</i> = .15, <i>P</i> = .004). Husband's education, socioeconomic status, and place of residence emerged as significant predictors of QoSL. Marital satisfaction was modestly associated with women's employment status and vehicle ownership. Perceived social support was positively influenced by socioeconomic status and number of children. Confirmatory factor analysis supported the structural relationships among the 3 constructs. Sexual quality of life and marital satisfaction are significantly shaped by social determinants such as education, occupation, socioeconomic status, and living conditions. These findings highlight the need for public health strategies and social policies that address structural inequalities to promote sexual and relational well-being among women.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":"63 ","pages":"469580251411402"},"PeriodicalIF":3.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13168712/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147870431","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":"Linking External Variables to the Prediction of Anxiety and Suicide Attempt Cases.","authors":"Carlos Rosa-Remedios, Noemi Gonzalez-Quintana, Jezabel Molina-Gil, Pino Caballero-Gil","doi":"10.1177/00469580261437171","DOIUrl":"10.1177/00469580261437171","url":null,"abstract":"<p><p>The increasing pressure on mental health systems requires innovative surveillance strategies. This study addresses the prediction of anxiety cases and suicide attempts by analyzing emergency call records, enriched with external variables (socioeconomic, educational, and meteorological) to identify comprehensive determinants of mental health crises at the population level. The methodology followed developed a dual predictive framework. For resource planning, time series algorithms (SARIMA, Prophet, ETS) were applied to predict the expected volume of cases. For Risk Profiling (Classification), multiple Supervised Machine Learning models (notably XGBoost and Random Forest) were used to classify specific incidents, distinguishing between Anxiety and Suicide Attempt. The relevance of the characteristics was rigorously analyzed using SHAP explainability techniques. In addition, a pilot study was introduced to explore the feasibility of Quantum Machine Learning (QML) algorithms. Time series models confirmed an upward trend and high volatility in 2023. In classification, nonlinear algorithms generally outperformed linear ones. SHAP analysis revealed that demographic factors (age, sex) and geographic location are more determinant predictors than economic variables, while solar radiation showed a significant inverse relationship with call volume. The results of the QML pilot, although limited, show a future avenue for expanding the study. The results obtained, using emergency service (PSAP) data combined with external determinants support evidence-based strategies for risk stratification and enable resource planning and targeted public health interventions, underscoring the need for locally adapted implementation and robust ethical safeguards in mental health crisis management.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":"63 ","pages":"469580261437171"},"PeriodicalIF":3.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13150084/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147789668","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}