Risk Management and Healthcare Policy最新文献

{"title":"Prevalence and Associated Factors of Self-Reported Coronary Heart Disease: A Population-Based Cross-Sectional Survey in Tianjin.","authors":"He Jiao, Yingyi Zhang, Zhigang Guo","doi":"10.2147/RMHP.S497216","DOIUrl":"https://doi.org/10.2147/RMHP.S497216","url":null,"abstract":"<p><strong>Objective: </strong>To describe the prevalence of self-reported coronary heart disease (CHD) and assess the influence of varied risk factors on it in Tianjin.</p><p><strong>Methods: </strong>This study included a total of 102,576 individuals aged 35 to 75 from 13 community health centers and grassroots hospitals in Tianjin. Basic information, questionnaire responses, physical examinations, and laboratory tests of each participant were researched, and documented. Participants were categorized into CHD group and non-CHD group. Multivariate logistic regression was utilized to evaluated the relationships between associated factors and CHD.</p><p><strong>Results: </strong>The prevalence of self-reported CHD was 2.56%, 3.97% among men and 1.69% among women. In multivariate logistic regression analysis, older age (41-65 years: OR: 7.37, 95% CI: 4.56-11.94; >65 years: OR:17.88, 95% CI: 11.02-29.01), female sex (OR: 0.40, 95% CI: 0.36-0.44), education (sedentary level: OR: 0.88, 95% CI: 0.79-0.97; high level: OR: 0.74, 95% CI: 0.63-0.87), family annual income (10,000-50,000 yuan: OR: 0.68, 95% CI: 0.60-0.77; >50,000 yuan: OR: 0.71, 95% CI: 0.62-0.82), recently drinking habits (2-4 times /month: OR: 0.75, 95% CI: 0.63-0.90; 2-3 times/week: OR: 0.69, 95% CI: 0.56-0.86; >4 times/week: OR: 0.72, 95% CI: 0.63-0.83), obesity (OR: 1.17, 95% CI: 1.07-1.28), central obesity (OR: 1.51, 95% CI: 1.33-1.71), hypertension (OR: 1.60, 95% CI: 1.43-1.80), dyslipidemia (OR: 0.90, 95% CI: 0.83-0.98), diabetes mellitus (OR: 2.02, 95% CI: 1.85-2.19), stroke (OR: 1.42, 95% CI: 1.24-1.63), family history (CVD: OR: 4.48, 95% CI: 4.00-5.01; stroke: OR: 1.83, 95% CI: 1.58-2.12) were associated with CHD (<i>P</i> < 0.05).</p><p><strong>Conclusion: </strong>These findings highlight growing concerns regarding the escalating rates of CHD. Implementing multifaceted, population-based interventions is crucial to mitigate the burden of cardiovascular conditions.</p><p><strong>Clinical trial registry number: </strong>The study received approval from the Ethics Committee of Tianjin Chest Hospital (approval number: 2018KY-003-01). Written informed consent was obtained from all survey participants.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"17 ","pages":"3137-3145"},"PeriodicalIF":2.7,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11648535/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142840332","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":"Development and Validation of the Resident Healthcare-Seeking Culture Scale (RHCS) Among Chinese Demographics in the Community Setting.","authors":"Hongbin Xu, Jie Feng, Lei Qiu, Shijiao Yan, Liqing Li, Qingfeng Tian, Yan He, Zuxun Lu","doi":"10.2147/RMHP.S462808","DOIUrl":"https://doi.org/10.2147/RMHP.S462808","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to develop a measurement scale with good reliability and validity to assess the reasonableness of resident healthcare-seeking culture.</p><p><strong>Methods: </strong>This investigation utilized a cross-sectional research design, employing a multi-stage random sampling technique to select adult inhabitants aged eighteen and above who possess fundamental literacy abilities. An online survey was conducted from March to April 2021 across 27 provinces in China, encompassing 911 questionnaires for scale development. This study primarily applied discriminant coefficients and exploratory factor analysis to refine the scale items. Scale reliability was assessed using Cronbach's alpha, and split-half reliability. Scale validity was determined through content validity and structural validity. Data analysis was performed using SPSS 21.0, and structural equation modeling was executed with AMOS 23.0 software. Statistical significance was defined at <i>P</i><0.05.</p><p><strong>Results: </strong>The Resident Healthcare-seeking Culture Scale (RHCS) ultimately comprised 5 dimensions and 20 items. The cumulative explained variance of the five common factors within this scale amounts to 55.24%, satisfactorily adhering to the established criterion of social science research that the extracted factors should explain between 50% and 60% of the total variance. The Cronbach's alpha coefficient for the total scale was 0.83. Split-half reliability was 0.87. The Pearson correlation coefficients associating the scores from the five dimensions with the overall scale score were 0.78, 0.65, 0.65, 0.64, and 0.42, respectively, all statistically significant with P-values less than 0.001. The results of confirmatory factor analysis suggested that RMR=0.045, GFI=0.952, AGFI=0.936, PGFI=0.712, NFI=0.917, IFI=0.944, TLI=0.931, CFI = 0.943, and RMSEA = 0.046.</p><p><strong>Conclusion: </strong>The measurement scale for healthcare-seeking culture among Chinese residents exhibits superior reliability and validity, serving as an effective instrument for hospital administrators to evaluate the reasonableness of demand-side healthcare culture.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"17 ","pages":"3147-3159"},"PeriodicalIF":2.7,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11648546/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142840322","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":"Exploring Adolescent Moderate-to-Vigorous Physical Activity in China: Mediating Roles of School Climate, Perceived Barriers, and Physical Education Satisfaction.","authors":"Qianyuan Li, Li Li, Xianyi He, Huilin Wang","doi":"10.2147/RMHP.S497472","DOIUrl":"https://doi.org/10.2147/RMHP.S497472","url":null,"abstract":"<p><strong>Background: </strong>The lack of physical activity poses a major challenge to adolescents' healthy physical and mental development. Despite growing attention, research on how the school physical activity climate affects Chinese adolescents' participation in moderate-to-vigorous physical activity (MVPA) remains scarce. This study explores this relationship through the lens of ecological systems theory, focusing on the mediating roles of physical education satisfaction and perceived barriers. It also proposes strategies to promote MVPA among Chinese adolescents.</p><p><strong>Methods: </strong>This cross-sectional study employed convenience and snowball sampling methods to examine the impact of the school physical activity climate on adolescent participation in MVPA. It also explored the mediating roles of physical education satisfaction and perceived barriers. Four variables in the study were measured using established scales: Physical Activity Climate, Perceived Barriers to Physical Activity, Physical Education Satisfaction, and Physical Activity Assessment. The data were analyzed using AMOS v.23 to construct and test a structural equation model.</p><p><strong>Results: </strong>A total of 612 adolescents aged 12 to 18 from six key middle schools in central China participated in the study. The findings showed that a positive school physical activity climate significantly promotes MVPA participation. Physical education satisfaction positively correlated with MVPA (<i>β</i> = 0.322, <i>p</i> < 0.001), while perceived barriers negatively correlated with both physical education satisfaction (<i>β</i> = -0.449, <i>p</i> < 0.001) and MVPA (<i>β</i> = -0.366, <i>p</i> < 0.001). Satisfaction with physical education and perceived barriers mediated the relationship between the school climate and MVPA, emphasizing their importance in shaping adolescent physical activity behavior. Confirmatory factor analysis (CFA) results (χ²/df = 1.928, GFI = 0.969, AGFI = 0.956, NFI = 0.962, CFI = 0.981, RMSEA = 0.037) confirmed the model's robustness and good fit.</p><p><strong>Conclusion: </strong>Adolescents in a positive physical activity climate are more likely to overlook perceived barriers, enjoy higher satisfaction in PE classes, and actively engage in MVPA. Schools and educators are advised to foster a supportive physical activity environment to boost adolescent MVPA participation, considering the unique context of China's educational system.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"17 ","pages":"3125-3136"},"PeriodicalIF":2.7,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11648554/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142840327","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":"Short-Form Video Applications Usage and Functionally Dependent Adults' Depressive Symptoms: A Cross-Sectional Study Based on a National Survey.","authors":"Chen Li, Yangyang Wang","doi":"10.2147/RMHP.S491498","DOIUrl":"https://doi.org/10.2147/RMHP.S491498","url":null,"abstract":"<p><strong>Objective: </strong>This study constructed a theoretical model based on the social compensation theory and used it to investigate the effects of short-form video applications usage on depressive symptoms among functionally dependent adults.</p><p><strong>Methods: </strong>An empirical analysis was conducted based on a national sample of 8752 adults aged 45+ from China Family Panel Studies (CFPS) wave 2020. This study examined the effects of short-form video applications usage on depressive symptoms in functionally dependent adults by constructing linear regression models. Further, the mediating effect of interpersonal relationship, and the moderating effect of video games were then sequentially analyzed with the help of macro PROCESS4.0 tool.</p><p><strong>Results: </strong>Results showed that: (1) short-form video applications usage significantly reduced the level of depressive symptoms among functionally dependent adults; (2) interpersonal relationship exerted a mediating effect of 10.36% in the process of short-form video applications usage reducing the level of depressive symptoms among functionally dependent adults; (3) video games attenuated the healing effect of short-form video applications usage on the level of depressive symptoms in functionally dependent adults, but not significantly in the functionally dependent adults aged 60+.</p><p><strong>Conclusion: </strong>New electronic media, represented by short-form video applications, have the potential to intervene in the mental health of functionally dependent adults. Social policymakers should consider adopting relevant e-healing measures to enhance the well-being of vulnerable groups.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"17 ","pages":"3099-3111"},"PeriodicalIF":2.7,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11646470/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142831037","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":"Declining Influenza Vaccination Uptake, Attitudes, and Knowledge Among Healthcare Workers in Chengdu, China, in the Post-COVID-19 Era.","authors":"Lin Xu, Shaohua Chen, Chunmei Li, Xiaogang Zhou, Li Tang","doi":"10.2147/RMHP.S490301","DOIUrl":"10.2147/RMHP.S490301","url":null,"abstract":"<p><strong>Purpose: </strong>Despite the benefits of influenza vaccination, particularly for healthcare workers (HCWs) at higher risk, vaccination coverage among HCWs in China remains low. This study aims to provide updated insights into the knowledge, attitudes, practices, and barriers related to influenza vaccination among HCWs in China post-COVID-19 era, to inform strategies for improving vaccination rates and healthcare safety.</p><p><strong>Methods: </strong>A cross-sectional survey was conducted between December 2023 and January 2024 at two tertiary hospitals in Chengdu, China. Logistic regression analyses were used to identify factors associated with HCWs' influenza vaccination uptake for the 2023-2024 season.</p><p><strong>Results: </strong>Of the 602 HCWs who completed the questionnaire (response rate: 86.0%), influenza vaccination uptake for the 2023-2024 season was low at 14.1%, down from 31.2% in 2021-2022 and 18.4% in 2022-2023. Main reasons for vaccine hesitancy included mistrust of vaccines (56.0%), inconvenient access (52.0%), and concerns over time, cost, and information (57.6%). Although most HCWs acknowledged the protective benefits of vaccination, only one-third supported mandatory vaccination, with concerns about personal autonomy among opponents. Multivariable logistic regression analysis showed that HCWs were more likely to be vaccinated if they believed it was essential for their job [adjusted odds ratio (aOR): 2.21; 95% confidence interval (CI): 1.13, 4.30), recognized their higher risk (aOR: 2.37; 95% CI: 1.09, 5.15), and were aware of high-risk groups for influenza vaccination (aOR: 2.49; 95% CI: 1.41, 4.40) as well as the age group with a higher infection rate (aOR: 1.89; 95% CI: 1.01, 3.51). However, those favoring increased campaign visibility had lower vaccination rates (aOR: 0.38; 95% CI: 0.17, 0.82).</p><p><strong>Conclusion: </strong>The persistently low influenza vaccination rates among HCWs in China post-COVID-19 highlight significant gaps in healthcare risk management. Targeted interventions, including enhanced education and better vaccine access, are needed, along with further discussion on mandatory vaccination as a potential solution.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"17 ","pages":"3049-3063"},"PeriodicalIF":2.7,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11646393/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830948","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":"Including Health System Capacities into the Assessment Framework of a Temperature-Resilience Health System.","authors":"Jingyi Zhao, Xiaowei Hao, Xiaofeng Sun, Yajie Du, Meng Zhang, Qing Wang","doi":"10.2147/RMHP.S494486","DOIUrl":"https://doi.org/10.2147/RMHP.S494486","url":null,"abstract":"<p><strong>Introduction: </strong>This study includes health system capacities into the assessment framework of a temperature-resilience health system while accounting for system interactions.</p><p><strong>Methods: </strong>In accordance with the guidelines provided by the World Health Organization, the conceptual framework of a climate-resilient health system has been adopted. The International Health Regulations are utilized to assess the health system capacities in 171 countries from year 2011 to 2019. Exploratory factor analysis and reliability tests have been conducted to confirm the validity and reliability of the framework. Moreover, a data-driven decision-making trial and evaluation laboratory method is employed to quantify the interactions among the structured aspects.</p><p><strong>Results: </strong>The assessment framework consists of five aspects, namely high temperature-sensitive risks, low temperature-sensitive risks, low-temperature exposure, vulnerability factors and health system capacities. Globally, the mean (standard deviation) for addressing the first four aspects are 0.77 (0.14), 0.87 (0.13), 0.88 (0.21), 0.72 (0.17), respectively, and health system capacities reach 0.67 (0.17). This study identifies health system capacities as the main driving forces. Interactions between it and other aspects call for multisectoral and coordinated actions. On a global scope, low-temperature exposure and its health risks, with the strongest dependence, should be prioritized to enhance temperature resilience, especially in high-income countries. In order to mitigate these risks, it might be necessary to disrupt the cascade effects resulting from low-temperature exposure by leveraging the capacities of coordination and multisectoral communication. Notably, low-income countries are more affected by high-temperature exposure, thus requiring flexible ways to strengthen temperature resilience.</p><p><strong>Discussion: </strong>Our study underscores the significance of health system capacities in strengthening a temperature-resilient health system. Undoubtedly, the development of the temperature-resilient health system ought to follow a coordinated and flexible approach, giving priority to dealing with low-temperature exposure.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"17 ","pages":"3085-3098"},"PeriodicalIF":2.7,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11646442/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142831022","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 Impact of a New Case-Based Payment System on Quality of Care: A Difference-in-Differences Analysis in China.","authors":"Xinyu Zhang, Mengcen Qian, Jiaqi Yan, Ruixin Wang, Dawei Lyu, Xiaohua Ying, Shenglan Tang","doi":"10.2147/RMHP.S488825","DOIUrl":"10.2147/RMHP.S488825","url":null,"abstract":"<p><strong>Purpose: </strong>China has developed and widely piloted a new case-based payment, ie, the \"Diagnosis-Intervention Packet\" (DIP) payment, which has a granular classification system. We evaluated the impact of DIP payment on the quality of care in a large pilot city in China and explored potential mechanisms of quality change.</p><p><strong>Methods: </strong>The city started to implement DIP payment with a hospital-level cap on July 1, 2019. Using a 5% random sample of discharge records from July 2017 to June 2021, we employed a difference-in-differences approach to compare two mortality measures (in-hospital mortality, mortality of surgical patients), two readmission measures (all-cause readmission within 30 days, readmission with the same principal diagnosis within 30 days) and a patient safety measure (operation associated complications or adverse event) in 13 pilot hospitals and 27 non-pilot hospitals before and after DIP payment reform.</p><p><strong>Results: </strong>Of 122,637 discharge records included, 43,023 (35.1%) were from pilot hospitals. After DIP payment, the readmission rate within 30 days and readmission rate with the same principal diagnosis in pilot hospitals decreased significantly by 3.2 percentage points (<i>P</i> <0.001) and 1.8 percentage points (<i>P</i> <0.001), respectively. The in-hospital mortality rate, the mortality rate of surgical patients, and the rate of operation-associated complications or adverse events did not have significant changes. The decrease in quality measures was primarily driven by tertiary hospitals, was more obvious over time after the policy adoption, and was more pronounced in groups with higher intensity of care.</p><p><strong>Conclusion: </strong>This study indicated that DIP payment with a cap in the study city was associated with improved quality of care among patients in pilot hospitals. The provider's behavior of increasing the intensity of care, especially for more severe patients, may partially contribute to the results.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"17 ","pages":"3113-3124"},"PeriodicalIF":2.7,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11646386/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142831043","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":"How Public Service Accessibility Affects Health of Migrants: Evidence from China.","authors":"Jingqian Li, Yu Wang","doi":"10.2147/RMHP.S475634","DOIUrl":"https://doi.org/10.2147/RMHP.S475634","url":null,"abstract":"<p><strong>Background: </strong>The effects of public service accessibility on migrant health can provide insights for local governments to optimize public service resource allocation. This study aimed to investigate the relationship between public service accessibility and the health of heterogeneous migrant populations in China, as well as the underlying mechanisms of this relationship.</p><p><strong>Materials and methods: </strong>Data from the 2017 China Migrants Dynamic Survey were utilized, employing ordinary least squares, instrumental variable estimation, and mediating and moderating effect analyses.</p><p><strong>Results: </strong>Findings of the regression analysis suggest a positive association between public service accessibility and better health outcomes for migrants, particularly for less educated migrants. Mediating effect analysis revealed that both public service equalization and efficiency significantly mediate the relationship between public service accessibility and migrant health. Enhanced equalization of public services was strongly linked to improved health outcomes among less educated migrants. In contrast, improved public service efficiency significantly benefit highly educated migrants. Moderating effect analysis showed that administrative hierarchy and public service expenditure preference negatively influence the effects of public service accessibility on migrant health. This diminishing effect is more pronounced among less educated migrants in cities with higher administrative hierarchies and among highly educated migrants in cities with a higher proportion of public service expenditure.</p><p><strong>Conclusion: </strong>This study highlights the relationship between public service accessibility and improved migrant health. Its findings suggest that optimized allocation of public service resources could enhance health equity in China's migrant population.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"17 ","pages":"3065-3084"},"PeriodicalIF":2.7,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11646460/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142831017","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":"Understanding Healthcare Personnel's Perceptions About Reducing Low-Value Care: A Scoping Review.","authors":"Jiamin Li, Dan Yang","doi":"10.2147/RMHP.S494013","DOIUrl":"10.2147/RMHP.S494013","url":null,"abstract":"<p><strong>Objective: </strong>To systematically and comprehensively search the studies describing healthcare personnel's perceptions about reducing low-value care.</p><p><strong>Design: </strong>Scoping review.</p><p><strong>Methods: </strong>Evidence sources included PubMed, ProQuest and CINAHL databases from inception to 13th September 2023, along with grey literature, expert suggestions and reference lists from the included articles. Studies were included if they contained information about healthcare personnel's perceptions and involvement in reducing low-value care. The extracted data included general study characteristics, the type of low-value care of interest, clinical settings, and main findings related to healthcare personnel's perceptions. Three frameworks were used to guide the data synthesis. First, the main findings from the included studies were mapped onto the Process of De-adoption Framework to capture the aspects of low-value care that healthcare personnel focused on, including the identification of low-value care, barriers and facilitators to reducing low-value care, and intervention strategies. The identified barriers and facilitators were then mapped onto the relevant domains of the <i>Theoretical Domains Framework</i>. Finally, the intervention strategies, as informed by healthcare personnel's perceptions, were mapped to the <i>Cochrane Effective Practice and Organization of Care taxonomy framework</i>.</p><p><strong>Results: </strong>The 37 included studies were those published since 2011. Of these, 15 studies were conducted in the United States. Most included studies (n = 19) described low-value care not specific to a care measure. Twelve of the included studies described healthcare personnel's perceptions regarding the identification of low-value care, 34 studies described healthcare personnel's perceptions regarding influence factors to reducing low-value care and 18 studies described healthcare personnel's perceptions regarding intervention strategies to reduce low-value care. \"Knowledge\" (n = 16) and 'environmental context and resources' (n = 16) were the most common influence factors of reducing low-value care. \"Education\" was the most commonly discussed intervention strategy for reducing low-value care (n = 14).</p><p><strong>Conclusion: </strong>Healthcare personnel's perceptions focused on identifying low-value care, barriers and facilitators of reducing low-value care and intervention strategies to reduce low-value care. Education was potentially the main effect of the intervention strategies in addressing lack of knowledge, which is the main barrier to reducing low-value care. Future research should develop and implement intervention strategies to reduce low-value care based on healthcare personnel's perceptions.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"17 ","pages":"3029-3047"},"PeriodicalIF":2.7,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11629665/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142808745","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":"Improving the Process of Managing Psychosocial Risks in Organizations.","authors":"Pavlo Saik, Vitaliy Tsopa, Serhii Cheberyachko, Oleg Deryugin, Svitlana Sokurenko, Iryna Suima, Vasyl Lozynskyi","doi":"10.2147/RMHP.S488263","DOIUrl":"10.2147/RMHP.S488263","url":null,"abstract":"<p><strong>Introduction: </strong>Psychosocial risks (PSRs) are identified as one of the main modern occupational safety issues, primarily related to occupational stress, and need to be reduced to safe levels in accordance with international requirements. The research purpose is to improve the process of managing the PSRs in the occupational safety and health management systems of employees, taking into account the impact of psychosocial dangers in accordance with the requirements of ISO 45001:2018 and ISO 45003:2021 standards.</p><p><strong>Methods: </strong>To develop the process of managing the PSRs, a system analysis method is applied, which allows determining the structural relationships between the variable elements of dangerous psychosocial factors described in the ISO 45003:2021 standard.</p><p><strong>Results: </strong>The bow-tie model has been improved to determine the relationship between psychosocial dangers and the dangerous event occurrence - experiencing stress by an employee, taking into account the influence of various dangerous psychosocial factors, which provides for an additional risk level assessment for restoring the health of an employee who has experienced stress. The process of psychosocial risk management consisting of ten steps is proposed, which involves identifying the relationship between psychosocial dangers and consequences for human health, taking into account the impact of various dangerous psychosocial factors based on questionnaires, followed by analysis and processing of the duration and intensity of experiencing stress. To reduce the impact of subjective assessments of the duration and intensity of experiencing stress on the psychosocial risk level, it is proposed to take into account the value of individual perception of experiencing stress (stress resistance) and the employees' health condition.</p><p><strong>Discussion: </strong>The scientific novelty is to determine the psychosocial risk level as the sum of the risk values from the impact of each dangerous psychosocial factor, which are characteristic of aspects of work organization, social conditions at work, working environment, equipment, dangerous tasks and the level of employee health. The practical value is the development of scales for assessing the impact of dangerous psychosocial factors and a form for documenting the process of managing psychosocial risks with the indication of precautionary measures to control them.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"17 ","pages":"2997-3016"},"PeriodicalIF":2.7,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11626964/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142803573","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}