Risk Management and Healthcare Policy最新文献

{"title":"Deep Learning for Early Prediction of Adverse Events in Intensive Care Units Using Electronic Health Records: A Methodological Review.","authors":"Kai Wang, Hui Yan, Dongsheng Chen, Xin Tan, Han Chen, Xudong Lu, Huilong Duan, Shan Nan","doi":"10.2147/RMHP.S629368","DOIUrl":"10.2147/RMHP.S629368","url":null,"abstract":"<p><strong>Purpose: </strong>To provide a methodological synthesis of deep learning (DL) approaches for early prediction of preventable adverse events (AEs) in intensive care units (ICUs) using electronic health record (EHR) data, and to examine how intrinsic EHR data challenges affect model development, predictive performance, and clinical applicability.</p><p><strong>Methods: </strong>This review was designed as a methodological synthesis rather than a quantitative meta-analysis or statistical comparison. Seven databases were systematically searched to identify studies on early AE prediction in ICU settings using DL models. Eligible studies were screened based on predefined criteria, and data were extracted and synthesized qualitatively to analyze EHR data characteristics, DL architectures, and associated methodological challenges.</p><p><strong>Results: </strong>A total of 31 studies comprising 33 predictive models were included. These studies covered multiple preventable AEs, diverse ICU EHR datasets, and a range of DL architectures. Across studies with different prediction windows, reported AUROC values ranged from 0.75 to 0.95. Four studies used oversampling to address class imbalance. Despite the increasing use of advanced and hybrid architectures, three recurring methodological challenges remained: subtle early-stage risk signals, class imbalance, and heterogeneity. Overall, the effectiveness of DL-based AE prediction depends less on architectural novelty alone and more on whether models are explicitly designed around the data conditions under which preventable AEs emerge.</p><p><strong>Conclusion: </strong>Future studies should move beyond architecture-centered optimization and develop methodological strategies, such as multimodal learning, bias-aware modeling, and personalized prediction strategies. More attention should also be given to external and prospective validation, safe clinical use, and real-world effects on patient care and preventable harm.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"19 ","pages":"629368"},"PeriodicalIF":2.6,"publicationDate":"2026-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13604016/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149042027","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 Nomogram for Predicting Acute Skin Failure in Critically Ill Patients: A Prospective Study.","authors":"Hang Wei, Lijun Jiang, Beibei Wei, Wei Zeng, Yuxin Yang, Yahong Xu, Li Zhang","doi":"10.2147/RMHP.S614663","DOIUrl":"10.2147/RMHP.S614663","url":null,"abstract":"<p><strong>Purpose: </strong>Acute skin failure is a common skin injury in critically ill patients. This study aimed to develop a nomogram model to assess the risk of acute skin failure in critically ill patients.</p><p><strong>Methods: </strong>This study enrolled 230 ICU patients from a class III hospital in Nanjing for modeling development from August 2024 to February 2025, while 123 ICU patients were enrolled for external validation from March 2025 to May 2025. Lasso regression and logistic regression were used to analyze the independent prediction factors of acute skin failure in critically ill patients. The nomogram model was constructed with R 4.4.1 software, and the web calculator was developed. The model's predictive ability was evaluated using the area under the receiver operating characteristic (ROC) curve (AUC), calibration curves, and clinical decision curves. Finally, the Shapley additive explanation method (SHAP) was employed to improve the model's interpretability.</p><p><strong>Results: </strong>The results of the study showed that peripheral perfusion index (OR=0.523, <i>p</i><0.001), skin mottling score (OR=2.239, <i>p</i>=0.007), multiple organ dysfunction syndrome (OR=5.897, <i>p</i> =0.002), lactic acid (OR=1.754, <i>p</i>=0.002) and albumin (OR=0.828, <i>p</i>=0.007) were independent prediction factors for acute skin failure. The area under the curve (AUC) for the modeling set of this model is 0.959 (95% <i>CI</i>: 0.935 ~ 0.983), and for the validation set is 0.930 (95% <i>CI</i>: 0.875 ~ 0.983). The calibration curves and clinical decision curves demonstrate good concordance and the clinical applicability of the model.</p><p><strong>Conclusion: </strong>The nomogram model developed in this study for predicting ASF risk in critically ill patients demonstrates potentially useful predictive performance and assists caregivers in the early identification of high-risk ASF groups.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"19 ","pages":"614663"},"PeriodicalIF":2.6,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13594525/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149026686","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":"Illuminating Risk: An Ecological Analysis of Artificial Light at Night and Childhood Myopia Using State-Level US Data.","authors":"Min Ju Kang, Nathaniel LaBarre, Michael Karo, Rachel Soong, Thomas A Vida","doi":"10.2147/RMHP.S628850","DOIUrl":"10.2147/RMHP.S628850","url":null,"abstract":"<p><strong>Purpose: </strong>Childhood myopia is a growing global health concern, associated with serious vision complications later in life, including retinal detachment and myopic macular degeneration. While behavioral factors such as screen time and reduced outdoor exposure have been studied, the potential contribution of environmental light pollution, particularly artificial light at night (ALAN), remains underexplored at the population level.</p><p><strong>Methods: </strong>We analyzed 2019 data from 46 US states to examine the association between ALAN and the prevalence of childhood myopia (ages 0-17). VIIRS satellite-derived nighttime radiance was used as a proxy for outdoor ambient lighting. Using generalized additive modeling (GAM), we examined nonlinear associations while adjusting for behavioral (screen time, insufficient sleep) and structural (Medicaid coverage, uninsured children, vision screening, optometrist density, urbanization) factors. Multicollinearity was assessed using Spearman correlation and variance inflation factors.</p><p><strong>Results: </strong>The final GAM explained 65.3% of the deviance in childhood myopia prevalence (adjusted <i>R²</i> = 0.509). Higher ALAN was significantly associated with higher myopia prevalence (F = 8.39, p = 0.0068). Screen time showed a nonlinear relationship, whereas sleep deprivation showed an unexpected inverse association, potentially reflecting detection disparities. Medicaid coverage showed a U-shaped association, with both low and high coverage associated with higher prevalence. Vision screening rates were positively associated with myopia prevalence, likely reflecting improved detection. Urbanization, optometrist density, and the number of Asian children were not statistically significant.</p><p><strong>Conclusion: </strong>ALAN is a population-level correlate of childhood myopia in the US. Although not indicative of individual-level risk, its association warrants further ecological investigation and may merit consideration in environmental health and urban planning discussions. These findings highlight the multifactorial nature of pediatric refractive error and the value of integrating environmental exposure data into public health vision surveillance. Further individual-level research is needed to assess causal mechanisms.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"19 ","pages":"628850"},"PeriodicalIF":2.6,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13590006/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149013296","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":"A Structured Organizational Support Program to Improve Occupational Adaptation Among Newly Recruited Healthcare Professionals: A Mixed-Methods Study.","authors":"Zilong Feng, Wei Dong, Pengtao Yao, Jianxiong Ma, Wancheng Qiu, Yong Hu, Li Ma","doi":"10.2147/RMHP.S635413","DOIUrl":"10.2147/RMHP.S635413","url":null,"abstract":"<p><strong>Background: </strong>Newly recruited healthcare professionals may experience interpersonal, role-related, and psychological challenges during the transition to clinical practice that are insufficiently addressed by conventional technical orientation. This study explored occupational adaptation needs and preliminarily evaluated a structured organizational support program in a tertiary hospital in China.</p><p><strong>Methods: </strong>We conducted a mixed-methods intervention study at a tertiary hospital in Beijing. Twenty-eight newly recruited healthcare professionals participated in the needs assessment, and 10 participants with common occupational adaptation challenges completed an 8-month organizational support program comprising six structured group sessions. We used questionnaires, semi-structured interviews, and participant observation to assess professional skill adaptation, interpersonal interaction, team collaboration, and psychological stress adaptation.</p><p><strong>Results: </strong>All 28 participants reported a need for practical clinical skills training, while 26 (92.9%) reported a need for psychological support and stress-management guidance. Fourteen participants (50.0%) reported work-related stress, and 13 (46.4%) reported anxiety associated with overtime work. Among the 10 intervention participants, the overall occupational adaptation score increased from 36.1 to 46.9, with the largest increases observed in interpersonal interaction, team collaboration, and psychological stress adaptation. Participants and supervisors reported high satisfaction.</p><p><strong>Conclusion: </strong>The structured organizational support program was well accepted, and preliminary pre-post improvements in occupational adaptation were observed, supporting further evaluation in larger controlled studies.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"19 ","pages":"635413"},"PeriodicalIF":2.6,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13588240/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149008502","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":"A Competing-Risk Nomogram for in-Hospital Non-Suicidal Self-Injury Recurrence Using Inflammatory and Clinical Predictors.","authors":"Yujun Zhao, Wei Liu","doi":"10.2147/RMHP.S613194","DOIUrl":"10.2147/RMHP.S613194","url":null,"abstract":"<p><strong>Background: </strong>Non-suicidal self-injury (NSSI) recurrence is an important safety concern in psychiatric inpatient care. This study aimed to identify predictors of subsequent in-hospital NSSI recurrence and develop an internally validated prediction model accounting for discharge as a competing event.</p><p><strong>Methods: </strong>This single-center retrospective cohort included 842 psychiatric inpatients aged 12-40 years. Admission clinical characteristics and inflammatory biomarkers were collected within the first 24 hours, while NSSI occurring during this period was recorded separately as an early in-hospital behavioral predictor. Subsequent NSSI recurrence was analyzed using Fine-Gray proportional subdistribution hazards models, with discharge without recurrence treated as a competing event. Non-linear associations were examined using restricted cubic splines. Internal validation was performed using 1000 bootstrap resamples with optimism correction.</p><p><strong>Results: </strong>The 14-day cumulative incidence of NSSI recurrence was 13.8%. Baseline NLR showed a significant non-linear association with recurrence risk. For exploratory model simplification, a maximally selected Gray statistic identified 2.45 as a data-derived NLR cutpoint. The multivariable Fine-Gray model identified six predictors: NSSI during the first 24 hours (sHR, 2.15), primary borderline personality disorder diagnosis (sHR, 1.88), childhood trauma or abuse (sHR, 1.65), prior suicide attempts (sHR, 1.42), NLR >2.45 (sHR, 1.58), and HAMD score (sHR per point, 1.05). The apparent C-index was 0.765, with an optimism-corrected value of 0.751. Calibration was acceptable at 7 and 14 days, and decision curve analysis suggested potential net benefit across selected threshold ranges. In sensitivity analysis excluding early NSSI, the C-index was 0.741 and the remaining predictor associations were generally maintained.</p><p><strong>Conclusion: </strong>Clinical history, depressive symptom burden, early in-hospital self-injury, and baseline NLR were associated with subsequent NSSI recurrence. The non-linear NLR association warrants further investigation, whereas early NSSI primarily reflects an already active crisis. The nomogram remains a research-stage risk-support model and requires prospective external validation before clinical implementation.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"19 ","pages":"613194"},"PeriodicalIF":2.6,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13588241/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149009342","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 Untapped Potential of One Health in Somalia: A Call for Cross-Sectoral Action Against Persistent Infectious Diseases.","authors":"Abdiweli Mohamed Abdi, Mohamed Ismael Iman, Nor Haji Osman, Osman Mohamed Mohamud, Abdirahman Mohamed Jimale, Abdifatah Nour Rage, Mahad Ali Mohamud","doi":"10.2147/RMHP.S634270","DOIUrl":"https://doi.org/10.2147/RMHP.S634270","url":null,"abstract":"<p><p>Somalia faces recurrent infectious-disease threats shaped by interacting human, animal, environmental, and health-system vulnerabilities, including climate shocks, displacement, livestock-dependent livelihoods, weak water, sanitation and hygiene (WASH) conditions, zoonotic risks, antimicrobial resistance, and uneven surveillance and laboratory capacity. This policy-oriented narrative commentary examines these interconnected risks through a One Health and health-system risk-management lens and proposes a region-sensitive framework for prevention, preparedness, surveillance, and response. Its central argument is that recurrent outbreaks should not be viewed solely as isolated disease-specific emergencies, but as manifestations of interconnected risks that require coordinated One Health action. The commentary draws on a targeted, non-systematic synthesis of recent Somalia-specific peer-reviewed studies, surveillance updates, humanitarian reports, and institutional policy documents, supplemented by broader One Health guidance where relevant. Recent evidence includes more than 8,900 acute watery diarrhea/cholera cases by the end of 2025, 3,655 diphtheria cases across 65 districts in 2025, and 1,665 suspected measles cases during the first four weeks of 2026. The proposed conceptual framework links human health, animal health and zoonoses, and environmental and climate risks with six core system functions: multisectoral governance; integrated surveillance and data sharing; laboratory and veterinary systems; workforce capacity and community engagement; climate- and WASH-informed preparedness; and sustainable financing. Somalia has already established important One Health foundations, including multisectoral coordination, zoonotic disease prioritization, human disease surveillance, and an International Health Regulations-Performance of Veterinary Services (IHR-PVS) roadmap. The central policy proposition is to build on these foundations through a region-sensitive, government-led One Health system linking federal, state, district, and community levels. Embedding measurable One Health functions within existing preparedness and response structures may support more anticipatory, geographically responsive, and coordinated risk management while preserving essential disease-specific programs.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"19 ","pages":"634270"},"PeriodicalIF":2.6,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13578597/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148992616","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":"Disaster Preparedness Among Physicians in Underdeveloped Regions of Southwestern China: A Cross-Sectional Study of Disaster Response Competencies, Training Needs, and Policy Implications.","authors":"Yeyao Hu, Min Tian, Yanyan Yu, Yongqin Qian, Hongli Deng, Dingying Wang, Yishuang Li, Rui Xia, Qiong He","doi":"10.2147/RMHP.S560522","DOIUrl":"10.2147/RMHP.S560522","url":null,"abstract":"<p><strong>Introduction: </strong>Disaster preparedness among physicians is critical for effective medical response during emergencies, especially in underdeveloped regions with limited healthcare resources. However, evidence from such contexts remains scarce. This study was conducted in Guizhou Province, a representative underdeveloped region in southwestern China, to assess physicians' disaster response competencies and training needs, and to provide evidence for targeted healthcare policy and capacity-building strategies.</p><p><strong>Methods: </strong>A cross-sectional survey was conducted from June to August 2023 among physicians working in hospitals at various levels across Guizhou Province. The questionnaire included demographic and professional background information, a 46-item self-assessment of disaster response competencies, and a 51-item self-assessment of training needs related to disaster medicine education and training. All items were rated using a five-point Likert scale (1 = strongly disagree to 5 = strongly agree). Data were analyzed using descriptive statistics, Mann-Whitney <i>U</i>-tests, Kruskal-Wallis tests, and multivariable linear regression.</p><p><strong>Results: </strong>A total of 760 physicians completed the survey. The disaster response competency total score ranged from 46 to 230, with a median of 141 (IQR 131-181), indicating a low-to-moderate level of disaster preparedness. The training needs total score ranged from 51 to 255, with a median of 172 (IQR 153-243), reflecting moderate-to-high training needs. Multivariable linear regression showed that location of practice, hospital type, clinical department, and institutional support (presence of an in-hospital disaster rescue team and existence of a comprehensive emergency plan) were associated with physicians' disaster response competency scores (P < 0.05).</p><p><strong>Conclusion: </strong>Physicians in underdeveloped regions of southwestern China demonstrate notable gaps in disaster response competencies alongside substantial training needs. Tailored, context-specific disaster medicine education and training, supported by institutional support, should be integrated into healthcare policy and hospital management to strengthen system resilience and improve emergency medical response capacity in underdeveloped regions.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"19 ","pages":"560522"},"PeriodicalIF":2.6,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13570658/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148957355","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":"Forecasting Acute Hemorrhagic Conjunctivitis Incidence in Henan, China: A Comparative Study of Seasonal Autoregressive Fractionally Integrated Moving Average and Seasonal Autoregressive Integrated Moving Average Models.","authors":"Yongbin Wang, Ruiting Zhao, Weihang Liu, Fei Lin, Chunjie Xu","doi":"10.2147/RMHP.S625710","DOIUrl":"10.2147/RMHP.S625710","url":null,"abstract":"<p><strong>Background: </strong>Acute hemorrhagic conjunctivitis (AHC) is a highly contagious viral disease causing significant public health burden. Accurate forecasting is essential for timely intervention. The seasonal autoregressive integrated moving average (SARIMA) model is widely used, but the seasonal autoregressive fractionally integrated moving average (SARFIMA) model, which captures long-range dependence, may perform better for complex incidence series. This study compared the forecasting performance of SARFIMA and SARIMA models for AHC in Henan.</p><p><strong>Methods: </strong>Monthly AHC case data from January 2011 to June 2023 in Henan Province were analyzed. Data from January 2011 to June 2022 were used for model training, with the remaining 12 months reserved for testing. National-level data from mainland China were used for external validation. Model performance was assessed using mean absolute deviation (MAD), root mean square error (RMSE), mean absolute percentage error (MAPE), and mean error rate (MER).</p><p><strong>Results: </strong>AHC incidence showed a significant upward trend (average annual percentage change: 6.973%, 95% CI: 3.963%-10.071%) and a pronounced seasonal peak from March to September. The optimal models were SARIMA(0,1,2)(0,1,1)₁ ₂ and SARFIMA(0,0.410,2)(0,0.413,1)₁ ₂. SARFIMA outperformed SARIMA on most metrics in both training (MAD: 23.392 vs 24.599; MAPE: 0.132 vs 0.134; RMSE: 31.218 vs 31.339; MER: 0.124 vs 0.131) and test sets (MAD: 39.375 vs 48.850; MAPE: 0.237 vs 0.280; RMSE: 50.390 vs 57.358; MER: 0.184 vs 0.229), with a substantially better fit (AIC: 987.59 vs 1231.50). National validation confirmed SARFIMA's superiority for MAD, MAPE, and MER, although RMSE values were comparable between models.</p><p><strong>Conclusion: </strong>The SARFIMA model offers improved forecasting accuracy over SARIMA for AHC incidence in most metrics, suggesting its potential utility for public health surveillance. However, its application requires sufficient data length, and prospective validation is needed before operational deployment.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"19 ","pages":"625710"},"PeriodicalIF":2.6,"publicationDate":"2026-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13557171/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148921895","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":"Implementation of Direct Access Physiotherapy Policy in Saudi Arabia: Insights from Practicing Physiotherapists: A Cross-Sectional Study.","authors":"Mada A Al-Amoodi, Wadi B Alonazi, Shabana Tharkar, Khalid M Almutairi","doi":"10.2147/RMHP.S618536","DOIUrl":"10.2147/RMHP.S618536","url":null,"abstract":"<p><strong>Background: </strong>Direct access to physical therapy (DAPT) services has attracted global attention for its potential to promote healthcare coverage, access, and equity. This study investigated physical therapists' opinions on DAPT practice, including awareness, perceived barriers, potential benefits, and implications for healthcare.</p><p><strong>Methods: </strong>A cross-sectional study was used to survey 137 physical therapists from governmental, semi-governmental, and private centers. The Bury and Stokes tool was used to evaluate the DAPT opinions that were originally assessed in the views of World Confederation for Physical Therapy (WCPT) members on DAPT policy. The link to the questionnaire and informed consent was emailed to the physiotherapists. Data was reported in percentages and means as appropriate. Mann‒Whitney <i>U</i>-test and the Kruskal‒Wallis test were employed to explore associations between variables.</p><p><strong>Results: </strong>The physiotherapists demonstrated good theoretical knowledge (65.7%) and understanding of DAPT concepts (73%). The overall awareness score was 2.46 ± 0.48 out of 3. Many supported (80.3%) and were willing to practice DAPT (77.7%). Out of a total mean score of 5, major concerns include physicians' views score (3.32 ± 1.12), lack of evidence-based practices (3.07 ± 1.06), lack of professional competencies (3.01 ± 1.06), and payment models (3.2 ± 1.11). The documented advantages encompass enhanced patient satisfaction (4.19 ± 0.79), expedited services (4.32 ± 0.75), and elevated professional standing (4.33 ± 0.74). Senior practitioners demonstrated a higher level of awareness in comparison to their junior colleagues (score: 2.4 vs 2.6; p=0.004). Additionally, physiotherapists with over 25 years of clinical experience recognized the benefits of direct access over their counterparts with lesser experience (> 25 years' experience median score 4.5; vs median scores < 4 for all lesser experience groups; p<0.003).</p><p><strong>Conclusion: </strong>This study emphasizes physiotherapists' opinions and positive attitudes regarding the DAPT policy implementation in Saudi Arabia. Nevertheless, addressing the challenges identified through education, advocacy, policy adjustments, and collaboration between stakeholders can enhance the accessibility, quality, and overall delivery of physiotherapy services.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"19 ","pages":"618536"},"PeriodicalIF":2.6,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13555331/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148921923","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":"Regional Differences and Dynamic Evolution of High-Quality Medical Resources in China's Private Hospitals from 2017 to 2022.","authors":"Minghua Zhou","doi":"10.2147/RMHP.S615118","DOIUrl":"10.2147/RMHP.S615118","url":null,"abstract":"<p><strong>Objective: </strong>To analyze the regional differences and dynamic evolution of high-quality medical resource in China's private hospitals, and to provide a scientific basis for promoting the development of high-quality medical resources in private hospitals.</p><p><strong>Methods: </strong>The number of tertiary private hospitals was selected as the evaluation index of high-quality medical resources in private hospitals, and descriptive analysis, Dagum Gini coefficient, kernel density estimation, and rank-sum ratio (RSR) method were used to analyze the general situation, regional differences and dynamic evolution of high-quality medical resources in private hospitals from 2017 to 2022.</p><p><strong>Results: </strong>High-quality medical resources in private hospitals have increased from 228 in 2017 to 540 in 2022. In 2022, the base-rate growth rates based on 2016 are, in descending order, the northeastern region, the western region, the eastern region, and the central region. From 2017 to 2022, the Dagum Gini coefficients of high-quality medical resources in China's private hospitals ranged from 0.427 to 0.463. The Dagum Gini coefficient is highest in the eastern and western regions and lowest in the northeastern and central regions. From 2017 to 2022, the central point of the kernel density curve of high-quality medical resources in private hospitals is moving more and more to the right, and the right trailing tail of the kernel density curve is getting longer and longer. The results of grading private hospitals by RSR method show that Beijing, Hainan, Hubei, Chongqing, and Liaoning are in the good grade; Xinjiang, Ningxia, Tibet, and Shanghai are in the poor grade; the remaining 22 regions are in the medium grade.</p><p><strong>Conclusion: </strong>High-quality medical resources of private hospitals in China have continued to grow. The equalization degree of high-quality medical resources of private hospitals is low. The difference of high-quality medical resources of private hospitals is larger in the eastern and western regions, and smaller in the northeastern and central regions. High-quality medical resources of private hospitals are better in Beijing, Hainan, Hubei, Chongqing and Liaoning, and worse in Xinjiang, Ningxia, Tibet and Shanghai. Therefore, it is important to emphasize policy support and supporting measures to promote the development of private hospitals.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"19 ","pages":"615118"},"PeriodicalIF":2.6,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13552399/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148914505","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}