Risk Management and Healthcare Policy最新文献

{"title":"Postoperative Symptom Cluster in NSCLC Patients and Its Relationship with Social Support and Self-Efficacy: A Cross-Sectional Study.","authors":"Juan Cao, Keyu Chen, Lihong Gao, Dandan Yang, Wenjuan Zhang, Xiaheng Deng, Changpeng Liu, Qi Dai, Xinyi Xu, Fang Li","doi":"10.2147/RMHP.S518188","DOIUrl":"https://doi.org/10.2147/RMHP.S518188","url":null,"abstract":"<p><strong>Purpose: </strong>The study aimed to identify symptom clusters among NSCLC patients within 3 months postoperatively and analyze the relationships between symptom clusters and social support and self-efficacy.</p><p><strong>Methods: </strong>We conducted a cross-sectional study from January 1 to May 31, 2024, involving NSCLC patients undergoing surgery at hospitals in Jiangsu Province. Data were collected using the MD Anderson Symptom Inventory, the Perceived Social Support Scale (PSSS), and the Strategies Used by People to Promote Health (SUPPH).</p><p><strong>Results: </strong>Exploratory factor analysis revealed five distinct symptom clusters: respiratory distress, respiratory tract discomfort, physical exhaustion, digestive dysfunction, and nighttime disturbances. The severity of physical exhaustion and nighttime disturbances was negatively correlated with PSSS scores. Conversely, the severity of respiratory distress, respiratory tract discomfort, and digestive dysfunction symptoms was negatively correlated with SUPPH scores.</p><p><strong>Conclusion: </strong>Our findings may guide medical professionals in managing postoperative symptoms in NSCLC patients. Social support and self-efficacy appear to be significant factors influencing the severity of symptom clusters.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"18 ","pages":"1347-1354"},"PeriodicalIF":2.7,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12011036/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144060439","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 Autonomy Reform on the Efficiency of Public Hospitals in China: A DEA-ITSA Combination Analysis.","authors":"Ningbo An, Quan Zou, Ji-Bin Li, Kaiyuan Luo, Gang Sun, Xing Ni, Oudong Xia","doi":"10.2147/RMHP.S514512","DOIUrl":"https://doi.org/10.2147/RMHP.S514512","url":null,"abstract":"<p><strong>Purpose: </strong>Since 2014, China has been rolling out a new autonomy reform for public hospitals, aiming to enhance their efficiency and better utilize the health budgets. The purpose of this research is to assess the reform's success and explore its effects on hospital outcome efficiency, laying a foundation based on empirical evidence for future policy decisions.</p><p><strong>Methods: </strong>The data envelopment analysis(DEA) and interrupted time-series analysis (ITSA) approaches were combined to analyze the reform impacts on the 16 samples of Shenzhen municipal public hospitals in China, using data extracted from the Shenzhen Health Statistics Yearbook from 2002 to 2023.</p><p><strong>Results: </strong>The results revealed that from 2002 to 2023, 15 out of 16 sample hospitals achieved total factor productivity improvement in Shenzhen city of China, with the average growth rate of Malmquist total factor productivity index(MI) was 3.05% and the highest growth rate was 6.93%, yet only one hospital showing a growth rate of -0.02%. The results of ITSA show a significant intervention in 2014. After the policy intervention, the fixed reference Malmquist total factor productivity index(FRMI) for the general and the specialty hospital group increased at rates of 0.04680(P<0.000) and 0.1746(p<0.000) per year by the Newey-West model, similarly, the rates of 0.04689(P<0.000) and 0.1762(p<0.000) per year by the Prais-Winsten model.</p><p><strong>Conclusion: </strong>The reform has positively impacted public hospitals' total factor productivity(TFP). The TFP of the general hospitals was increasing before the policy intervention of autonomy hospitals, but the time of its implementation was associated with a more significant rise. Meanwhile, the TFP of specialty hospitals decreased before the intervention; however, its trend shifted to growth after the intervention. This research further emphasizes the applicability of the DEA-ITSA combination method as an effective tool for health policies evaluation using public data within China's healthcare framework.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"18 ","pages":"1333-1346"},"PeriodicalIF":2.7,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12009585/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144036308","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":"Cost-Effectiveness Analysis of Serplulimab Combined with Nab-Paclitaxel Plus Carboplatin Compared to Nab-Paclitaxel Plus Carboplatin Alone as First-Line Treatment for Advanced Squamous Non-Small Cell Lung Cancer in China.","authors":"Hongting Yao, Kai Xu, Man Yu, Xiaoye Wang, Yingzhi Lu, Xin Li, Hong Wu","doi":"10.2147/RMHP.S506976","DOIUrl":"https://doi.org/10.2147/RMHP.S506976","url":null,"abstract":"<p><strong>Purpose: </strong>The ASTRUM-004 trial demonstrated the efficacy of serplulimab combined with nab-paclitaxel plus carboplatin chemotherapy in untreated patients with advanced squamous non-small cell lung cancer (NSCLC). Our study aimed to evaluate the cost-effectiveness of this combination therapy compared to that of nab-paclitaxel plus carboplatin chemotherapy alone for advanced squamous NSCLC patients from the perspective of the Chinese healthcare system.</p><p><strong>Patients and methods: </strong>A partitioned survival model based on the survival data of the ASTRUM-004 trial was constructed to assess the cost-effectiveness. The direct medical costs and utilities were derived from published literature and real-world medical institutions. The total costs, quality-adjusted life years (QALYs), and incremental cost-effectiveness ratios (ICERs) were calculated. Sensitivity analyses and scenario analyses were conducted to assess the robustness of the model.</p><p><strong>Results: </strong>The base-case analysis revealed that serplulimab combined with nab-paclitaxel plus carboplatin chemotherapy provided 0.53 incremental QALYs at an incremental cost of $60,790.77, with an ICER of $114,207.24/QALY. The ICER significantly exceeded the Chinese willingness-to-pay threshold ($37,743.79/QALY). Body weight, the utility value of progression-free survival stage, and the price of serplulimab were the main influencing factors of the ICER. Probabilistic sensitivity analysis revealed that there was no possibility of cost-effectiveness under the current threshold. Scenario analyses revealed that this combination therapy would only be cost-effective if the price of serplulimab fell by at least 80.3%.</p><p><strong>Conclusion: </strong>Compared to nab-paclitaxel plus carboplatin chemotherapy alone, serplulimab combined with nab-paclitaxel plus carboplatin chemotherapy might not be economical for advanced squamous NSCLC patients in China under current pricing conditions. This study suggests that future price reductions for serplulimab could make this therapy more economically viable and provide guidance for drug pricing decisions.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"18 ","pages":"1309-1321"},"PeriodicalIF":2.7,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12009117/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144010902","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":"Research on Dynamic Outpatient Respiratory Nosocomial Infection Control Methods Through Multi-Data Prediction.","authors":"Yuncong Wang, Wenhui Ma, Yang Yang, Huijie Zhao, Zhongjing Zhao, Xia Zhao","doi":"10.2147/RMHP.S508760","DOIUrl":"https://doi.org/10.2147/RMHP.S508760","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to develop a dynamic prevention and control method for fluctuating respiratory nosocomial infections in outpatients.</p><p><strong>Methods: </strong>Six sets of surveillance data such as influenza-like case counts and their predicted results were used in the autoregressive integrated moving average model (ARIMA) to forecast the onset and end time points of the epidemic peak. A Delphi process was then used to build consensus on hierarchical infection control measures for epidemic peaks and plateaus. The data, predicted results, and hierarchical infection control measures can assist dynamic prevention and control of respiratory nosocomial infections with changes in the infection risk.</p><p><strong>Results: </strong>The ARIMA model produced exact estimates. The mean absolute percentage errors (MAPE) of the data selected to estimate the time range of the high-risk and low-risk periods were 15.8%, 9.2%, 15.4%, 16.8%, 25.6%. The hierarchical infection control measures included three categories and nine key points. A risk-period judgment matrix was also designed to connect the surveillance data and the hierarchical infection control measures.</p><p><strong>Conclusion: </strong>Through a mathematical model, dynamic prevention and control of respiratory tract infections in outpatients was constructed based on the daily medical service monitoring data of hospitals. It is foreseeable that when applied in medical institutions, this method will provide accurate and low-cost infection prevention and control outcomes.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"18 ","pages":"1323-1332"},"PeriodicalIF":2.7,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12009034/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055901","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":"Global Burden of Alzheimer's Disease Attributable to High Fasting Plasma Glucose: Epidemiological Trends and Machine Learning Insights.","authors":"Yixiao Ma, Shuohan Huang, Yahong Dong, Qiguan Jin","doi":"10.2147/RMHP.S506581","DOIUrl":"https://doi.org/10.2147/RMHP.S506581","url":null,"abstract":"<p><strong>Purpose: </strong>High fasting plasma glucose (HFPG) is a known risk factor for Alzheimer's disease (AD). This study aims to analyze global trends in AD death rates and disability-adjusted life years (DALYs) rates attributable to HFPG from 1990 to 2021 and assess the potential of glucose-related biomarkers in predicting cognitive impairment.</p><p><strong>Methods: </strong>Data from the Global Burden of Disease 2021 database were used to analyze AD death rates and DALY rates due to HFPG across 204 countries. All rates were age-standardized. Joinpoint regression, age-period-cohort models, and ARIMA were employed to analyze trends and make future predictions. NHANES data were used to build machine learning models (including logistic regression, SVM, random forests, etc). to evaluate glucose-related biomarkers in predicting cognitive impairment.</p><p><strong>Results: </strong>From 1990 to 2019, global AD death rates attributable to HFPG increased from 2.64 (95% UI: 0.11, 8.38) to 3.73 (95% UI: 0.15, 11.84), with the highest increases in high-income North America, North Africa, and Sub-Saharan Africa. DALY rates also rose globally, from 47.07 (95% UI: 2.72, 126.46) to 66.42 (95% UI: 3.83, 178.85). The greatest impact was observed in females, particularly those aged 80 and above. Joinpoint analysis indicated a significant rise in death rates from 1995 to 2000, followed by a slower increase in recent years. ARIMA model predictions indicate a gradual decline in death rates and DALY rates over the next 15 years. Logistic regression models showed the highest accuracy (90.4%) in predicting cognitive impairment, with 2-hour postprandial glucose and fasting plasma glucose being key predictors.</p><p><strong>Conclusion: </strong>From 1990 to 2021, global AD death rates and DALY rates due to HFPG significantly increased, with a greater burden in females and regions with higher socio-demographic development. Machine learning models are effective tools for identifying individuals at high risk of elevated blood glucose leading to cognitive impairment.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"18 ","pages":"1291-1307"},"PeriodicalIF":2.7,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12007509/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055805","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 Nomogram Model Integrating Inflammation Markers for Predicting the Risk of Recurrent Sciatica After Selective Nerve Root Blocks.","authors":"Meng Cai, Jing Yin, Yi Jin, HongJun Liu","doi":"10.2147/RMHP.S503360","DOIUrl":"https://doi.org/10.2147/RMHP.S503360","url":null,"abstract":"<p><strong>Background: </strong>Lumbar disc herniation (LDH) usually c auses sciatica. Although selective nerve root block (SNRB) is an effective, highly target-oriented interventional procedure for patients with LDH, accurately predicting the risk of sciatica recurrence in such patients after SNRB remains a major challenge.</p><p><strong>Objective: </strong>We aimed to construct a nomogram model by integrating clinical data, imaging features and inflammation markers that could predict recurrent sciatica following SNRB in LDH patients, which fill the inflammation data gaps during model construction.</p><p><strong>Methods: </strong>In total, 121 sciatica patients were enrolled and assigned to the recurrence group (n = 41) and non-recurrence group (n = 80). By performing the logistic regression analyses, we identified risk factors serving as independent predictors and constructed the nomogram prediction model. Then, the performance and clinical practicality of the nomogram model were validated by performing the receiver operating characteristic curve (ROC) analysis, calibration curve analysis, and decision curve analysis (DCA). The bootstrap method was applied for the internal validation of the nomogram model.</p><p><strong>Results: </strong>Preoperative sensory symptoms (odds ratio [OR] [95% confidence interval (CI)]: 2.933 [1.211-7.353]), type of herniation (OR [95% CI]: 2.712 [1.261-6.109]), and systemic inflammation response index (OR [95% CI]: 2.447 [1.065-6.271]) were included in the nomogram for predicting unfavorable outcomes following sciatica. The nomogram AUC was 0.764, and the prognostic precision, validated using the bootstrap method, reached 0.756. The ROC and calibration curve analyses, and DCA also produced excellent results, exhibiting favorable predictive performance and clinical benefit.</p><p><strong>Conclusion: </strong>This study thus identified risk factors that predict unfavorable outcomes after sciatica and developed a risk prediction model based on clinical, radiologic, and inflammatory factors, thereby facilitating early predictions by clinicians and offering an individualized medical interventions for patients with recurrent sciatica in early stages.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"18 ","pages":"1279-1289"},"PeriodicalIF":2.7,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12002072/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144063491","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":"Subject Modeling-Based Analysis of the Evolution and Intervention Strategies of Major Emerging Infectious Disease Events.","authors":"Haixiang Guo, Tiantian Zhao, Yuzhe Zou, Beijia Zhang, Yuyan Cheng","doi":"10.2147/RMHP.S507704","DOIUrl":"https://doi.org/10.2147/RMHP.S507704","url":null,"abstract":"<p><strong>Objective: </strong>Due to the popularity of the Internet and the extensive use of new media, after the occurrence of infectious diseases, the spread of social media information greatly affects the group's opinion and cognition and even the health behaviors they take, thus affecting the spread of infectious diseases. Therefore, this paper studies the event evolution from multiple dimensions.</p><p><strong>Methods: </strong>To address this gap, we developed a three-layer model framework of major infectious disease event evolution based on subject modeling. This framework integrates three key factors-health transmission, perspective interaction, and risk perception-to analyze group perspective evolution, behavioral change, and virus transmission processes. The model's effectiveness was evaluated through simulation and sensitivity analysis. In addition, we conducted an empirical analysis by constructing a social media health transmission effect index system to identify the critical factors affecting health transmission.</p><p><strong>Results: </strong>Simulation results reveal that among the three factors, health transmission has the most significant impact on the evolution of group perspectives during infectious disease events. Moreover, the dynamics of public viewpoint evolution influence individual decisions regarding the adoption of non-pharmacological interventions, which are shown to effectively reduce both the transmission rate of the virus and the peak number of infections.</p><p><strong>Conclusion: </strong>The findings of this study enhance our understanding of the complex mechanisms and evolutionary pathways in infectious disease events. By integrating multiple dimensions of event evolution, the proposed model offers valuable insights for the design of effective countermeasures and strategies in emergency management and response to infectious disease outbreaks.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"18 ","pages":"1257-1278"},"PeriodicalIF":2.7,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11998951/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144053567","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":"Unheard Struggles: Exploring Health-Related Quality of Life Determinants and Coping Mechanisms Among Children with Hearing Loss from Parents and Caregivers Perspective.","authors":"Ayoob Lone","doi":"10.2147/RMHP.S515485","DOIUrl":"https://doi.org/10.2147/RMHP.S515485","url":null,"abstract":"<p><strong>Purpose: </strong>Childhood hearing loss is an emerging public health concern. This study aimed to compare the quality of life (QOL) and coping strategies between children with and without hearing loss. It also explored the impact of coping strategies on the QOL of children with hearing loss.</p><p><strong>Methods: </strong>The study included 95 children with hearing loss and 107 healthy controls aged 6-18 years, recruited from special education schools. QOL was evaluated using the SF-12 health survey, and coping strategies were assessed with the Brief COPE inventory. Data analysis was conducted using descriptive and inferential statistics.</p><p><strong>Results: </strong>Children with hearing loss reported lower QOL scores in areas such as role functioning, emotional well-being, mental health, and physical health. They were more likely to use maladaptive coping strategies like denial, behavioral disengagement, and self-blame, whereas healthy children favored adaptive strategies like self-distraction, emotional support, and positive reframing. Problem-focused coping showed a positive association with role functioning (r = 0.46, <i>p</i> < 0.01), emotional roles (r = 0.18, <i>p</i> < 0.05), and mental health (r = 0.19, <i>p</i> < 0.05). Sociodemographic factors, including grade level and rural residence, significantly influenced QOL, with children in rural areas (OR = 4.66; <i>p</i> = 0.03) and lower grades (OR = 8.89; <i>p</i> = 0.05) facing greater challenges. Multiple regression analysis revealed a significant relationship between the self-distraction and physical component summary score (<i>p</i> = 0.01). Self-distraction (<i>p</i> = 0.01) and the acceptance coping strategy (<i>p</i> = 0.02) had a notable effect on the mental summary score of SF-12 scores of children with hearing loss.</p><p><strong>Conclusion: </strong>This study concluded that children with hearing impairment showed poor quality of life and these children use maladaptive coping strategies to combat with the stress caused by hearing loss. Early detection, community awareness, and customized support programs are crucial to enhancing the QOL of children with hearing loss and minimizing the condition's long-term impact.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"18 ","pages":"1241-1255"},"PeriodicalIF":2.7,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11993120/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144057464","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 Individual Mandate and Income on Private Health Insurance Enrollment: A State-Level Analysis on Individual Behavior Change.","authors":"Hyunji Kim, Jinyoung Cha, Jaeyoung Jang, Ahreum Han, Dongjin Oh, Keon-Hyung Lee","doi":"10.2147/RMHP.S501240","DOIUrl":"https://doi.org/10.2147/RMHP.S501240","url":null,"abstract":"<p><strong>Introduction: </strong>Health insurance, vital for improved health outcomes and reduced financial burdens, faced challenges within the market system due to adverse selection and the risk of a death spiral. This led to the Affordable Care Act (ACA) introducing the Individual Mandate in 2014. After the penalty under the Individual Mandate had been repealed, several states have kept regulative measures to encourage individuals to keep health insurance.</p><p><strong>Methods: </strong>This study analyzed the impact of individual mandates in four states and D.C. on private health insurance enrollment using pooled cross-sectional data from the Integrated Public Use Microdata Series (IPUMS) USA. The dataset included 4,524,753 non-elderly individuals (ages 19 to 64) from 2019 to 2021. A logistic regression model was employed to estimate the likelihood of having private health insurance, with the individual mandate as a state-level binary variable and income as a continuous predictor. Interaction effects between income and the mandate were examined. To further interpret the results, marginal effects were calculated to quantify the impact of the individual mandate and income on the probability of private health insurance enrollment.</p><p><strong>Results: </strong>The study revealed a positive association between the individual mandate regulation and increased private health insurance enrollment. Additionally, income exhibited a positive influence on enrollment in private health insurance coverage. Notably, when considering the moderating effect of income, the mandate had a more pronounced impact on lower-income individuals, resulting in a 0.885% decrease in the probability of having private health insurance for every 10k increase in individual income.</p><p><strong>Conclusion: </strong>The findings highlight that individuals in the mandated states are more likely to have private health insurance, addressing adverse selection issues and stabilizing the health insurance market. However, the mandate disproportionately affects lower-income individuals, suggesting the need for additional financial assistance to sustain enrollment. Policymakers should consider complementary support programs, such as subsidies and cost-sharing reductions, to mitigate financial burdens and ensure broader coverage. Maintaining an individual mandate alongside targeted financial policies can contribute to a more equitable and sustainable healthcare system.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"18 ","pages":"1229-1239"},"PeriodicalIF":2.7,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11992991/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144027297","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":"An Investigation into the Current Landscape, Challenges, and Training Imperatives of Clinical Research Among Anesthesiologists in China.","authors":"Yingjie Du, Ruirong Chen, Lili Wu, Quan Chen, Tiankuo Yu, He Li, Guyan Wang","doi":"10.2147/RMHP.S513667","DOIUrl":"https://doi.org/10.2147/RMHP.S513667","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to investigate the status of anesthesiologists in clinical research in China, identify challenges, and propose strategies to improve research quality and anesthesiology services.</p><p><strong>Materials and methods: </strong>A cross-sectional online survey was conducted among registered clinical anesthesiologists in China from April to May 2023. The questionnaire, which was developed by a multidisciplinary team following a workshop, covered sociodemographic characteristics, clinical research status, skills, motivations, challenges, and training needs. Data were analyzed using descriptive statistics, chi-square tests, and logistic regression to examine the factors associated with research publications.</p><p><strong>Results: </strong>Of the 878 analyzed respondents, 85.08% showed positive attitudes towards clinical research, yet the publication rates were low (59.68% in Chinese, 14.24% in English). Professional title promotions (78.70%) and solving clinical problems (69.48%) were the primary motivators. The respondents reported needing training in statistical analysis (74.69%), research design (73.86%), and topic selection (72.34%). The self-reported deficiencies included ability (73.01%), time (69.93%), and funding (60.71%). Significant differences (<i>P</i><0.01) existed between publishers and non-publishers regarding age, education, title, research experience, training, and hospital characteristics. Educational background, professional title, research experience, and training were identified as independent factors that influenced publication rates.</p><p><strong>Conclusion: </strong>This study identified major obstacles in anesthesiologists' research engagement, including time constraints, skill deficits, and funding issues, despite high interest. Career advancement was the primary motivation for the study. This study emphasizes the need for enhanced training in statistics and research designs. Factors such as education, title, experience, and training independently impact publication output.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"18 ","pages":"1217-1227"},"PeriodicalIF":2.7,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11992470/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144049648","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}