Risk Management and Healthcare Policy最新文献

{"title":"When Intensive Care is Perceived as a Place of Death: Family Decision Delay, Trust, and Financial Barriers to Timely Acceptance of ICU Admission in Somalia.","authors":"Ahmed Omar Siyad, Abdullahi Abdirahman Omar, Abdukadir Mohamed Hassan","doi":"10.2147/RMHP.S604907","DOIUrl":"10.2147/RMHP.S604907","url":null,"abstract":"<p><p>This article is an evidence-informed commentary and conceptual reflection on delays in accepting intensive care unit (ICU) admission or escalation in Somalia, informed by contextual clinical experience and relevant literature rather than primary empirical measurement. In some families, ICU transfer may be interpreted not as a setting for advanced monitoring and potentially life-saving support, but as a sign that death is imminent. Such interpretations may be influenced by prior bereavement experiences, fear of separation from the patient, uncertainty about care quality and outcomes, financial barriers within a predominantly out-of-pocket system, and family-centered decision structures in which elders or household heads may authorize major care decisions. ICU services and workforce capacity have expanded gradually in urban Somali settings, including Mogadishu, yet public understanding of ICU purpose and processes may remain limited. We propose a context-informed conceptual pathway of ICU decision delay and outline a practical response framework emphasizing clear family explanation, structured communication and trust-building, respectful counseling of fear and grief, and feasible approaches to reduce immediate financial barriers at the point of escalation decisions to support timely acceptance of ICU admission or escalation when indicated.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"19 ","pages":"604907"},"PeriodicalIF":2.6,"publicationDate":"2026-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13184542/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147984470","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":"Normalization of Risk in Primary Care: Revealing Latent Safety Threats Through Simple Digital Monitoring in Family Medicine.","authors":"Adriana-Lavinia Cioca, Marius Cioca, Bogdan Mihai Neamtu","doi":"10.2147/RMHP.S601882","DOIUrl":"10.2147/RMHP.S601882","url":null,"abstract":"<p><strong>Introduction: </strong>Increasing workload, time pressure, and administrative demands in family medicine create conditions in which delays in routine preventive and monitoring activities may gradually become normalized. When such delays are no longer perceived as exceptional, they can evolve into latent safety threats that remain largely invisible in everyday clinical practice. This study explores whether a simple digital monitoring approach can support the visibility and management of normalized risk in a primary care setting.</p><p><strong>Methods: </strong>This exploratory, single-site, practice-based quality improvement initiative was conducted in a family medicine setting. A lightweight digital monitoring dashboard was used to track routine preventive and chronic care recommendations over time, based on commonly accepted follow-up intervals. Overdue actions were identified through comparison between expected timing and recorded completion, using routinely available clinical data integrated into everyday workflows.</p><p><strong>Results: </strong>At baseline, a small number of overdue recommendations (including at least one active delay distributed across multiple care domains) were identified, with a temporal pattern suggestive of accumulating latent risk. Following targeted clinical follow-up, a partial reduction in delays was observed, with improvement across care domains. In the final observation phase, all overdue recommendations were resolved (0 active delays), suggesting a transition toward a more stable and lower-risk operational state within the observed practice context.</p><p><strong>Conclusion: </strong>These findings suggest that simple, low-cost digital monitoring tools may help support the visibility and management of normalized risk in family medicine. By making routine delays visible, such approaches may enhance situational awareness and support timely clinical follow-up in resource-constrained primary care environments.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"19 ","pages":"601882"},"PeriodicalIF":2.6,"publicationDate":"2026-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13180369/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147977617","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 Application of a Unplanned Extubation Assessment and Clinical Decision Support Information System.","authors":"Huayu Chen, Xiaowen Yang, Jifang Peng, Xianrong Xu, Yaping Li, Zirong Tong, Chunhong Gao","doi":"10.2147/RMHP.S594033","DOIUrl":"10.2147/RMHP.S594033","url":null,"abstract":"<p><strong>Background: </strong>Unplanned extubation (UE) poses significant risks to intensive care unit (ICU) patients, including respiratory complications and increased mortality. Existing preventive measures are limited by delayed detection and inconsistent nursing practices. This study aimed to develop and evaluate an Unplanned Extubation Assessment and Clinical Decision Support Information System (UE-CDSS) to reduce UE incidence and enhance catheter management.</p><p><strong>Methods: </strong>The UE-CDSS was developed using a C#-based client-server architecture and SQL Server database, integrating 12 core risk indicators, including limb muscle strength, delirium status, and catheter type. The indicators were selected through two rounds of Delphi expert consultation. The system comprises five modules: catheter maintenance, risk assessment and restraint decision, critical patient restraint support, virtual catheter ward, and analysis and feedback. A pre-post study design was applied to compare UE incidence, catheter management metrics, and nurse satisfaction in a tertiary hospital ICU before (2021, n=1,059) and after (2022-2023, n=4,115) system implementation.</p><p><strong>Results: </strong>UE incidence significantly declined for all catheter classes: Class I from 1.08% to 0.38%, Class II from 1.36% to 0.27%, and Class III from 0.44% to 0%. Catheter fixation rates improved from 97.21% to 99.50%, secondary fixation from 95.13% to 97.80%, and standardized restraint from 96.61% to 98.83% (all P<0.001). Nurse satisfaction scored 92.15±6.82/115, reflecting high usability.</p><p><strong>Conclusion: </strong>The UE-CDSS effectively reduces UE incidence and enhances catheter care standardization, demonstrating clinical utility and nurse acceptance. The system's closed-loop management framework provides practical guidance for nurses and a scalable approach for improving patient safety in ICUs.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"19 ","pages":"594033"},"PeriodicalIF":2.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13142709/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147846594","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 of Ambient Air Pollution and Pregnancy Outcomes Among Women with Assisted Reproductive Technology in Qingdao, China: A Retrospective Cohort Study.","authors":"Shuyuan Chen, Zewei Yu, Yuquan Mao, Yangying Xu, Fanhui Meng, Duan Li, Xueyu Wang, Yupeng Jia, Xiaowen Liu, Yujie Li, Cuifang Hao, Xin Du","doi":"10.2147/RMHP.S562528","DOIUrl":"10.2147/RMHP.S562528","url":null,"abstract":"<p><strong>Background: </strong>Ambient air pollutants, a major global public health concern, have been widely documented in recent years as key risk factors for adverse reproductive system outcomes. Assisted reproductive technology (ART) has become an important therapeutic means for infertility, but its pregnancy outcomes are influenced by various environmental factors. Thus, we explored the effects of ambient air pollutants on populations undergoing ART.</p><p><strong>Methods: </strong>The retrospective cohort study included 3478 infertility patients with fresh embryo transplantation residing in Qingdao City who underwent in vitro fertilization and intracytoplasmic sperm injection in China from 2021 to 2023. We employed multivariable logistic regression to assess the effects of contaminants on oocyte quality, embryonic development, and pregnancy outcomes. Stratified analysis was conducted to identify potential vulnerable subpopulations.</p><p><strong>Results: </strong>Regression showed that NO₂ exposure showed negative association with biochemical pregnancy rates (aOR=0.967, 95% CI=0.935-0.999) and clinical pregnancy rates (aOR=1.044, 95% CI=1.001-1.088). CO exposure was positively correlated with cleavage rate (aOR=1.293, 95% CI=1.048-1.594) and day 3 high-quality embryo rate (aOR=1.462, 95% CI=1.054-2.028). PM_2.5 and NO₂ exposure were negatively associated with the number of oocyte retrieval and MII oocytes. WQS index was negatively correlated with MII oocyte count (aOR=0.916, 95% CI=0.857-0.978). BKMR analysis confirmed PM_2.5 correlated negatively with MII oocyte count. Stratified analyses revealed women aged ≥35 were more sensitive to NO₂, while those <35 were to O₃. Women with ≥7 oocytes were more sensitive to PM_2.5 and NO₂.</p><p><strong>Conclusion: </strong>Ambient air pollutants exert significant negative effects on ART-related reproductive outcomes. Women aged ≥35 were more sensitive to NO₂, whereas those <35 were O₃. Women with ≥7 oocytes were more sensitive to PM_2.5 and NO₂. This study provides a scientific basis for the prevention of air pollution and clinical decision-making in ART population. It is necessary to develop personalized intervention strategies for sensitive populations and strengthen the environmental control of related pollutants.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"19 ","pages":"562528"},"PeriodicalIF":2.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13142272/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147846616","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":"Privacy, Security & Governance Frameworks for AI-Powered Wearable Internet of Health Things in Elderly Care: A Comprehensive Review.","authors":"Dhika Dharmansyah, Laili Rahayuwati, Iqbal Pramukti, Kuswandewi Mutyara","doi":"10.2147/RMHP.S606165","DOIUrl":"10.2147/RMHP.S606165","url":null,"abstract":"<p><p>The global aging population is expanding at an unprecedented rate, with projections indicating that 1.4 billion people will be aged 60 years or older by 2030 and 2.1 billion by 2050, placing immense pressure on healthcare systems worldwide. Artificial intelligence (AI)-powered wearable Internet of Health Things (IoHT) devices - including smartwatches, biosensors, and continuous health monitors - have emerged as transformative tools for real-time elderly health monitoring, fall detection, and predictive analytics. However, the massive collection of sensitive biometric data by these devices raises critical concerns regarding privacy, security, and governance that remain insufficiently addressed, particularly for elderly populations. This comprehensive review synthesizes evidence from 333 peer-reviewed articles published between 2018 and 2025 cross PubMed, Scopus, Web of Science, IEEE Xplore, and Google Scholar to identify, analyze, and compare governance frameworks for AI-powered wearable IoHT in elderly care. The analysis reveals significant regulatory fragmentation across jurisdictions: while the European Union's General Data Protection Regulation (GDPR) and AI Act provide the most comprehensive rights-based framework, the United States relies on a patchwork of sector-specific regulations with notable gaps for consumer wearables, and Asia-Pacific nations exhibit highly variable approaches ranging from mature (Singapore, Japan) to nascent (Indonesia, Malaysia). Elderly-specific provisions remain conspicuously absent across all regulatory regimes examined. This review proposes a novel five-layer integrative governance framework - the first to unify technical security, privacy protection, ethical AI governance, regulatory compliance, and person-centered governance specifically designed for elderly care contexts. The framework addresses unique vulnerabilities associated with cognitive decline, reduced digital literacy, and caregiver dependency. Findings underscore the urgent need for harmonized, age-sensitive regulatory approaches and privacy-preserving technologies such as federated learning and differential privacy to ensure that AI-powered wearable IoHT fulfills its promise of enhancing elderly healthcare without compromising dignity, autonomy, or data security.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"19 ","pages":"606165"},"PeriodicalIF":2.6,"publicationDate":"2026-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13117830/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147790024","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":"Application of a Nursing Quality Improvement Checklist in the Emergency Treatment of Trauma Patients.","authors":"Lang Fan, Ling Zhang, Qiong Huang, Maolin Deng, Weijun Guo, Dan Chang, Yuan Yuan, Yan Zhou, Bo Bi, Yanhong Kang","doi":"10.2147/RMHP.S578784","DOIUrl":"10.2147/RMHP.S578784","url":null,"abstract":"<p><strong>Objective: </strong>To explore the value of applying a nursing quality improvement checklist in a pre-post quasi-experimental design in the treatment of emergency trauma patients.</p><p><strong>Methods: </strong>A total of 779 trauma patients were admitted to the emergency department of Changsha Traditional Chinese Medicine Hospital from April 2024 to November 2024. Patients treated between April and July 2024 were assigned to the control group (417 cases), and those treated between August and November 2024 were assigned to the observation group (362 cases). The control group received routine treatment, while the observation group implemented a nursing quality improvement checklist management approach integrating traditional Chinese medicine (TCM) elements based on routine treatment. The study compared the emergency department length of stay (ED-LOS), time to CT completion, resuscitation success rate, incidence of nursing adverse events, and patient satisfaction between the two groups, analyzed using t-tests and chi-square tests.</p><p><strong>Results: </strong>The observation group had a significantly shorter ED-LOS (reduced by 28.14 minutes) compared to the control group (P < 0.01). The occurrence of nursing adverse events was markedly lower in the observation group than in the control group (P < 0.05). Additionally, the resuscitation success rate was significantly higher in the observation group compared to the control group (P < 0.05). Patient satisfaction was also greater in the observation group than in the control group (P < 0.01).</p><p><strong>Conclusion: </strong>Implementing a risk-based nursing quality improvement checklist for trauma patients was associated with reduced ED-LOS, decreased incidence of nursing adverse events, and enhanced both resuscitation success rates and doctor-patient satisfaction. Limitations include single-center design; future multicenter studies are needed.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"19 ","pages":"578784"},"PeriodicalIF":2.6,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13110749/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147789996","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 a Postoperative LEDVT Risk Assessment System for Severe Traumatic Brain Injury.","authors":"Minling Mo, Dahong Zhai, Nina Tao, Na Zhang, Yajuan Zhang, Guqing Zeng","doi":"10.2147/RMHP.S585801","DOIUrl":"10.2147/RMHP.S585801","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to develop a structured risk assessment system for postoperative lower extremity deep vein thrombosis (LEDVT) in patients with severe traumatic brain injury (sTBI), and to validate its content and reliability through expert consensus.</p><p><strong>Methods: </strong>The system was designed based on evidence from a comprehensive literature review and refined through a two-round Delphi expert consensus process involving 16 multidisciplinary experts. Indicator weights were assigned using an analytic hierarchy process combined with expert scoring.</p><p><strong>Results: </strong>The finalized framework incorporated 6 primary domains-demographic characteristics, trauma-related indicators, coagulation parameters, comorbidities, iatrogenic factors, and venous thromboembolism prophylaxis-encompassing 19 secondary indicators. Response rates for two rounds of the expert questionnaire were 100%. The expert authority coefficient was 0.931. The coefficients of variation for the second-round indicators ranged from 0% to 7.01% and Kendall's coefficient of concordance was 0.670 (<i>p <</i> 0.001), indicating a high degree of expert agreement.</p><p><strong>Conclusion: </strong>A comprehensive risk prediction indicator system for LEDVT following sTBI surgery was established. The system is suitable for direct integration into hospital information systems, with weighted indicators reflecting clinical priorities and supporting the development of real-time monitoring modules.By enabling early identification of high-risk patients, this tool can facilitate timely prophylactic interventions, enhance clinical decision-making, and ultimately reduce the incidence of postoperative LEDVT, thereby improving patient safety and overall quality of care.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"19 ","pages":"585801"},"PeriodicalIF":2.6,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13110019/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147790046","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":"Comparative Evaluation of Patient-Reported Experience in Day Surgery Under International JCI and National Accreditation in Kazakhstan.","authors":"Kaisar Kudabayev, Aigul Ismailova, Kenesh Dzhusupov, Gulnar Mustafinova, Yerlan Naubetov, Saulemai Bekeyeva, Bakhyt Yeleussizova, Didar Kadyrbek, Oxana Tsigengagel","doi":"10.2147/RMHP.S598301","DOIUrl":"10.2147/RMHP.S598301","url":null,"abstract":"<p><strong>Aim: </strong>Healthcare quality management requires robust, evidence-based evaluation of organizational frameworks. Building on prior findings regarding healthcare professionals' perspectives, this study aimed to evaluate quality management frameworks by examining three-year trends (2023-2025) in patient-reported experience measures (PREMs) across Joint Commission International JCI accredited and nationally accredited institutions within Kazakhstan's day surgery sector.</p><p><strong>Methods: </strong>A repeated cross-sectional, comparative study was conducted among 600 patients in Astana (n=100 per cohort per year). A validated 19-item questionnaire assessed clinical trust, digital maturity, and financial transparency. Statistical analysis employed Pearson's Chi-square tests for gap analysis, Binary Logistic Regression to determine independent predictors of institutional loyalty (Odds Ratios), and Multivariate Cluster Analysis (PCA-style) to map quality zones.</p><p><strong>Results: </strong>Over the three years, a trend of narrowing quality gaps was identified. JCI-accredited institutions were associated with higher ratings in perceived physician competence and digital maturity (56.0% online booking). High physician competence emerged as the primary predictor of loyalty (OR = 4.12; 95% CI: 2.80-6.10, p<0.001), indicating that patients perceiving high competence were four times more likely to recommend the facility. In nationally accredited polyclinics, loyalty ratings increased from 51.0% in 2023 to 74.0% in 2025 (p<0.001). However, in high-tier centers, a significant association was found between high out-of-pocket diagnostic costs (90.0%) and negative perceptions of financial transparency (45.0% in 2025).</p><p><strong>Conclusion: </strong>JCI accreditation is associated with clinical and digital excellence, while national standards correlate with improvements in the service baseline of primary care. The study suggests that sustainable modernization requires management frameworks that balance clinical protocols with infrastructure scalability and transparent financial counseling to maintain institutional integrity.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"19 ","pages":"598301"},"PeriodicalIF":2.6,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13110811/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147789991","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 Tuberculosis Treatment Outcomes in Somalia: A Narrative Review of Strategies, Challenges, and Policy Recommendations.","authors":"Jamal Hassan Mohamoud","doi":"10.2147/RMHP.S595510","DOIUrl":"10.2147/RMHP.S595510","url":null,"abstract":"<p><p>Tuberculosis (TB) remains a major public health concern in Somalia, driven by prolonged conflict, population displacement, fragile health systems, and adverse social determinants of health. Although Somalia has made progress in expanding TB services and achieving favourable treatment outcomes for drug-susceptible TB, the country continues to experience a high TB burden and emerging drug-resistant tuberculosis (DR-TB). Persistent challenges include delayed diagnosis, treatment interruption, catastrophic patient costs, paediatric TB care gaps, and reliance on external donor funding. This narrative review synthesizes evidence from peer-reviewed articles, programmatic reports, and international guidelines to examine TB treatment outcomes, key challenges, and current strategies in Somalia. Literature was searched in PubMed, Google Scholar, and Scopus databases, as well as relevant grey literature from the World Health Organization and humanitarian organizations. Publications between 2010 and 2024 were considered, and 35 studies were identified, of which 15 met the inclusion criteria and were included in the final synthesis. The findings highlight the importance of decentralized and community-based care, rapid molecular diagnostics, multimodal adherence support, shorter all-oral DR-TB regimens, and integration of TB services with nutrition and humanitarian support. Strengthening health system resilience and prioritizing vulnerable populations are essential for sustaining improvements in TB treatment outcomes in Somalia and other fragile settings.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"19 ","pages":"595510"},"PeriodicalIF":2.6,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13098548/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147790026","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 State of Anesthesia and Critical Care Services in Somalia: Challenges and Opportunities.","authors":"Ibrahim Abdullahi Mohamed, Bashiru Garba","doi":"10.2147/RMHP.S593539","DOIUrl":"10.2147/RMHP.S593539","url":null,"abstract":"<p><p>Anesthesia and critical care are indispensable to safe surgery, obstetric care, trauma management, and emergency response, yet they remain underdeveloped in Somalia. This commentary provides a policy-oriented narrative synthesis of available peer-reviewed literature and institutional reports describing workforce capacity, service readiness, and critical care infrastructure. Evidence consistently indicates a very low density of physician anesthesiologists (approximately 0.2 per 100,000), limited availability of functional intensive care unit (ICU) beds, and gaps in essential resources such as monitoring, oxygen, medications, and reliable electricity. In many settings, care relies on non-physician anesthesia providers with variable access to structured training, supervision, and regulation, particularly outside major cities. These system constraints contribute to avoidable perioperative and critical illness risk pathways, including delayed access to emergency interventions, hypoxemia, medication errors, and limited rescue capacity for complications. Despite these challenges, feasible opportunities exist. Priorities include strengthening governance and standards for safe anesthesia practice, expanding training and supervised task-sharing models, improving oxygen and power reliability, and implementing low-cost safety systems such as checklists and standard protocols. Coordinated national planning aligned with global benchmarks and universal health coverage agendas is essential to guide investment and accountability.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"19 ","pages":"593539"},"PeriodicalIF":2.6,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13092440/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147789983","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}