Risk Management and Healthcare Policy最新文献

{"title":"Application of Modified Early Warning Score System (MEWS) in the Assessment of Disease Condition and Prognosis of Patients After Neurosurgical Procedure or Intervention.","authors":"Ping Liu, Jiao Xu, Yuhua Liu, Xuexuan Wang, Qili Tan, Ying Wang","doi":"10.2147/RMHP.S532103","DOIUrl":"10.2147/RMHP.S532103","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the safety and clinical utility of the corrected Modified Early Warning Score (MEWS) system in predicting postoperative clinical deterioration and long-term prognosis in neurosurgical patients.</p><p><strong>Methods: </strong>A prospective cohort study was conducted on 344 neurosurgical patients admitted between December 2021 and April 2022. Physiological parameters including axillary temperature, respiratory rate, heart rate, systolic blood pressure, arterial oxygen saturation, and consciousness level were systematically recorded. Patients were monitored for clinical deterioration and final outcomes over a 90-day postoperative period. Receiver operating characteristic (ROC) curve analysis was performed with 90-day mortality as the primary endpoint.</p><p><strong>Results: </strong>The study demonstrated a significant correlation between elevated corrected MEWS scores and clinical severity (p<0.001). ROC analysis revealed excellent predictive accuracy for 90-day mortality (AUC=0.944), with an optimal cutoff value of 4.5 points demonstrating high sensitivity (92.9%) and specificity (82.0%). The maximum Youden's index of 0.749 further confirmed the robust discriminative capacity of this threshold.</p><p><strong>Conclusion: </strong>The corrected MEWS scoring system shows strong predictive validity for postoperative clinical deterioration and long-term outcomes in neurosurgical patients.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"18 ","pages":"2693-2699"},"PeriodicalIF":2.0,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12372822/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144980132","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 Relationship Between Cancer Cognition, Coping Ability and Behavioral Intention of Secondary Cancer Prevention Among Rural Residents in Shandong Province.","authors":"Wenning Sun, Xingli Ma, Ao Zhang, Yingjie Wang, Boyang Fan, Huifang Zhang, Haining Yu, Haipeng Wang","doi":"10.2147/RMHP.S533410","DOIUrl":"10.2147/RMHP.S533410","url":null,"abstract":"<p><strong>Background: </strong>Secondary prevention plays a crucial role in reducing cancer-related deaths. Previous studies have indicated that cancer cognition and coping ability significantly influence behavioral intention towards secondary prevention. However, limited research has explored the relationship between the three, particularly among rural residents. Rural areas often face challenges like limited healthcare access and lower health literacy, impacting prevention intentions. This study aims to explore the path associations between cancer cognition, coping ability, and behavioral intention for cancer secondary prevention among rural residents.</p><p><strong>Methods: </strong>A cross-sectional survey was conducted in Shandong Province, China, from August 10 to September 10, 2023. Using a multi-stage stratified random sampling method, 453 valid questionnaires were obtained. Univariate and bivariate analysis were conducted for preliminary assessment, and structural equation modeling (SEM) was used to examine the relationships among cancer cognition, coping ability, and secondary prevention intention.</p><p><strong>Results: </strong>22.3% of participants reported an intention to engage in secondary cancer prevention. Cancer cognition was positively associated with both prevention intention (β=0.06, p<0.001) and coping ability (β=0.82, p<0.001), while coping ability was also positively associated with prevention intention (β=0.64, p<0.001). The SEM demonstrated a good model fit (GFI=0.841, CFI=0.916, IFI=0.916, TLI=0.906, RMSEA=0.056, SRMR =0.036, AGFI=0.812, PGFI=0.715).</p><p><strong>Conclusion: </strong>Cancer cognition positively influences coping ability, which subsequently increases the intention to engage in secondary prevention among rural residents in Shandong Province. Tailored interventions to improve cancer cognition and coping ability are vital for enhancing prevention intention among rural residents.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"18 ","pages":"2701-2711"},"PeriodicalIF":2.0,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12372809/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144979599","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":"Evaluation of Health Resource Efficiency and Its Influencing Factors in Ethnic Minority Areas of Guangxi: Data from 2010 to 2022.","authors":"Zhuanzhi Tang, Ajuan Tang, Zhe Sun, Gai Cao, Rong Cao","doi":"10.2147/RMHP.S534921","DOIUrl":"10.2147/RMHP.S534921","url":null,"abstract":"<p><strong>Objective: </strong>Measuring the efficiency of health resources is one of the tools for determining how resources are utilized. Considering the necessity of assessing health resource efficiency, this study aims to evaluate the efficiency of health resource allocation and its influencing factors in Guangxi, a minority region.</p><p><strong>Methods: </strong>An input-oriented Data Envelopment Analysis (BCC-DEA) and the Malmquist index model were employed to analyze the static and intertemporal efficiency of health resource allocation in 14 cities in Guangxi from 2010 to 2022. Finally, a Tobit regression model was used to estimate the factors influencing health resource allocation efficiency.</p><p><strong>Results: </strong>Since the implementation of the new healthcare reform in 2009, the quantity of health resources in Guangxi has increased substantially. The average annual growth rate of total factor productivity change for health resources from 2010 to 2022 was 4.6%. However, the overall efficiency of health resource allocation remained low at 0.675, falling short of DEA effectiveness, with notable disparities across cities. Tobit regression analysis indicated that per capita disposable income (β = 0.252, 95% CI = 0.000-0.505) and the proportion of healthcare expenditure (β = 0.011, 95% CI = 0.004-0.017) were positively associated with efficiency scores, while population density (β = -0.001, 95% CI = -0.0007 - -0.0002) was negatively associated. These findings were further validated through a two-stage bootstrap truncated regression.</p><p><strong>Conclusion: </strong>The efficiency of health resource allocation in Guangxi remains in need of improvement due to issues such as insufficient technological innovation and an unscientific allocation of resource scale. It is recommended that relevant authorities increase investments in health funding and technological innovation, improve institutional mechanisms, and allocate health resources in a scientific and rational manner.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"18 ","pages":"2713-2730"},"PeriodicalIF":2.0,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12372844/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144980085","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":"Evaluation of Three Large Language Models' Response Performances to Inquiries Regarding Post-Abortion Care in the Context of Chinese Language: A Comparative Analysis.","authors":"Danyue Xue, Sha Liao","doi":"10.2147/RMHP.S531777","DOIUrl":"10.2147/RMHP.S531777","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to evaluate the response performances of three large language models (LLMs) (ChatGPT, Kimi, and Ernie Bot) to inquiries regarding post-abortion care (PAC) in the context of the Chinese language.</p><p><strong>Methods: </strong>The data was collected in October 2024. Twenty questions concerning the necessity of contraception after induced abortion, the best time for contraception, choice of a contraceptive method, contraceptive effectiveness, and the potential impact of contraception on fertility were used in this study. Each question was asked three times in Chinese for each LLM. Three PAC consultants conducted the evaluations. A Likert scale was used to score the responses based on accuracy, relevance, completeness, clarity, and reliability.</p><p><strong>Results: </strong>The number of responses received \"good\" (a mean score > 4), \"average\" (3 < mean score ≤ 4), and \"poor\" (a mean score ≤ 3) in overall evaluation was 159 (88.30%), 19 (10.57%), and 2 (1.10%). No statistically significant differences were identified in the overall evaluation among the three LLMs (<i>P</i> = 0.352). The number of the responses evaluated as good for accuracy, relevance, completeness, clarity, and reliability were 87 (48.33%), 154 (85.53%), 136 (75.57%), 133 (73.87%), and 128 (71.10%), respectively. No statistically significant differences were identified in accuracy, relevance, completeness or clarity between the three LLMs. A statistically significant difference was identified in reliability (<i>P</i> < 0.001).</p><p><strong>Conclusion: </strong>The three LLMs performed well overall and showed great potential for application in PAC consultations. The accuracy of the LLMs' responses should be improved through continuous training and evaluation.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"18 ","pages":"2731-2741"},"PeriodicalIF":2.0,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12372831/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144978859","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":"Limitations of Observational Study Designs When Comparing Lung Isolation Techniques [Letter].","authors":"R Peter Alston","doi":"10.2147/RMHP.S554314","DOIUrl":"10.2147/RMHP.S554314","url":null,"abstract":"","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"18 ","pages":"2691-2692"},"PeriodicalIF":2.0,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12363998/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144979036","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":"Effect of Educational Intervention on Healthcare Workers' Basic Life Support Knowledge and Practice in a Rural Tertiary Hospital in South Western Uganda.","authors":"Elias Twinomujuni, Eric Baluku Murungi, Ambrose Tumwesigye, John Bosco Tamu Munezero, Samuel Olowo, Vallence Niyonzima, Eva Wanyenze","doi":"10.2147/RMHP.S534142","DOIUrl":"10.2147/RMHP.S534142","url":null,"abstract":"<p><strong>Background: </strong>Basic Life Support (BLS) is critical for timely recognition and response to cardiac and respiratory arrest. However, BLS knowledge and practice remain low among healthcare workers in Uganda, especially in rural areas. Limited research has evaluated the effectiveness of structured BLS training intervention in such a setting. This study assessed the effect of an educational intervention on healthcare workers' BLS knowledge and practice at Kitagata Hospital in Sheema District, Uganda. The intervention involved face-to-face educational training combined with high-fidelity simulation. BLS knowledge was assessed using a 13-item questionnaire, while practice was evaluated using a 23-point simulation checklist. Pre- and post-intervention scores were compared using paired t-tests.</p><p><strong>Methods: </strong>A quasi-experimental study using quantitative methods was conducted among 30 healthcare workers from Kitagata Hospital in Sheema district, Uganda. The intervention involved face-to-face educational training combined with high-fidelity stimulation. BLS knowledge was assessed using a 13-item questionnaire, while practice was evaluated using a 23-point stimulation checklist. Pre- and postintervention scores were compared using <i>t</i>-test. Data were analysed using STATA version 18. A paired <i>t</i>-test evaluated the training's effect, and ANOVA compared outcomes across health worker categories.</p><p><strong>Results: </strong>The training intervention significantly improved BLS knowledge and practice among participants. The mean knowledge score was 4.87 (SD= 14.67) pretest and 12.47 (SD= 7.49) posttest, <i>p</i> < 0.001. The mean self-perceived self-practice score was 2.57 (SD= 17.76) pretest and 9.37 (SD= 7.65) posttest, <i>p</i> < 0.001; and researcher-observed practice improved by 11 (47.8%), SD 3.52, <i>p</i> = 0.001. Qualification level and experience had no significant impact on these outcomes.</p><p><strong>Conclusion: </strong>Baseline BLS knowledge and practice among health workers at Kitagata Hospital were poor. The educational intervention significantly enhanced both knowledge and practice. Simulation-based training proved effective in improving practical skills. Hospital administrations should regularly conduct refresher BLS trainings, provide accessible guidelines in strategic hospital areas, and integrate BLS into health worker training curricula. Future research should explore healthcare workers' perceptions and attitudes toward BLS and identify barriers and facilitators to its application in clinical settings.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"18 ","pages":"2653-2674"},"PeriodicalIF":2.0,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12360364/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144884343","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":"Revisiting Global HPV Vaccination Behavior and Its Determinants: A Comprehensive Review.","authors":"Yiwen Guo, Xulin Liu, Stephen Nicholas, Elizabeth Maitland, Rugang Liu","doi":"10.2147/RMHP.S524223","DOIUrl":"10.2147/RMHP.S524223","url":null,"abstract":"<p><strong>Purpose: </strong>Human papillomavirus (HPV) infection and the resulting penile, anal, oropharyngeal and cervical cancer impact the health and welfare of men and women. The HPV vaccine has emerged as the most effective method to combat HPV. This study comprehensively analyzes the key influencing factors of global HPV vaccination behavior.</p><p><strong>Methods: </strong>This systematic review synthesizes evidence on global HPV vaccination behaviors and determinants. We searched three major databases PubMed, Web of Science and Scopus for peer-reviewed literature published between 2018 and 2023. Studies from diverse geographical regions and population subgroups were analyzed using thematic synthesis and narrative approaches.</p><p><strong>Results: </strong>In the published literature, men and men who have sex with men (MSM) were under-represented groups. Both subjective and objective determinants influenced HPV vaccination behavior, including parental attitudes, knowledge of health professionals and gendered views about HPV risks. In the studies reviewed, HPV vaccination rates were low globally, with few countries achieving vaccination rates above 70%.</p><p><strong>Conclusion: </strong>Key HPV vaccination determinants included education level, parental attitudes, knowledge and awareness of HPV and its vaccine and acceptance of the HPV vaccine. Based on the literature survey, we provide recommendations for governments and health institutions to improve gender-specific HPV vaccination rates, including MSM.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"18 ","pages":"2675-2689"},"PeriodicalIF":2.0,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12360388/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144884344","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 Evolving Global Epidemiology of Presenile Dementia in People Aged Under 65: A 40-year Cross-Sectional Study.","authors":"Dan Zhao, Yingjie Luo, Binfa Ouyang, Li Wang, Shan Xu, Yijin Zheng, Xiaolin Peng, Xuan Zhong","doi":"10.2147/RMHP.S534291","DOIUrl":"10.2147/RMHP.S534291","url":null,"abstract":"<p><strong>Aim: </strong>Despite presenile dementia substantial impact on patients, caregivers, and healthcare systems, comprehensive global assessments of its burden are lacking. This research aims to address this knowledge gap by investigating the trends in the epidemiology of presenile dementia since 1990 and forecast to 2030, providing essential evidence for healthcare policy and resource planning.</p><p><strong>Methods: </strong>This cross-sectional, population-based study leveraged data for individuals aged 40-64 years of presenile dementia from the GBD study, which performed a detailed evaluation related metrics across 204 countries. We calculated age-standardized rates for incidence, mortality, and DALYs. Projections were generated using a Bayesian APC model based on historical trends. SDI quintiles were used to assess disparities across countries.</p><p><strong>Results: </strong>The global age-standardized incidence rate of presenile dementia is expected to rise to 43.97 per 100,000 population by 2030 (EAPC, 0.07 [95% CI: -0.02-0.17]). However, age-standardized death and DALY rates are forecasted to decline to 2.61 (EAPC, -0.01 [95% CI: -0.07-0.05]) and 113.38 per 100,000 (EAPC, -0.05 [95% CI: -0.10-0.00]), respectively. Women are expected to exhibit higher incidence rates than men (47.13 vs 40.94 per 100,000 in 2030), reflecting consistent sex-based disparities. Incidence, death, and DALY rates are projected to continue to rise in low SDI countries.</p><p><strong>Conclusion: </strong>The overall burden of presenile dementia remains substantial due to continued increases in incidence rates, particularly pronounced in low-resource settings. These findings underscore the urgent need for targeted prevention strategies, particularly in low-resource settings, and continued investments in health care infrastructure to address disparities. Expanding screening programs to younger populations globally could help reduce the associated burden of dementia.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"18 ","pages":"2639-2651"},"PeriodicalIF":2.0,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12358499/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144884345","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":"Retrospective Cohort Study: Nomogram for 1-Year in-Stent Restenosis After PCI in Coronary Heart Disease.","authors":"Xin-Fu Cao, Dao-Hai Chen, Ya-Li Qiu, Chao Tang, Xiao-Long Li, Zhen-Hua Gu","doi":"10.2147/RMHP.S533714","DOIUrl":"10.2147/RMHP.S533714","url":null,"abstract":"<p><strong>Objective: </strong>To construct a nomogram for risk prediction of in-stent restenosis (ISR) within one year after percutaneous coronary intervention (PCI) for coronary heart disease (CHD).</p><p><strong>Methods: </strong>This study included 842 patients with severe CHD who underwent PCI at Changzhou Affiliated Hospital of Nanjing University of Chinese Medicine between March 2016 to March 2024. Based on the occurrence of ISR within one year post-PCI, patients were stratified into two groups: the ISR group (n=112) and the non-ISR group (n=730). Potential risk factors were initially identified using LASSO regression, followed by multivariate logistic regression to determine independent predictors. A nomogram prediction model was developed using R software (version 4.2.6) and internally validated via the bootstrap resampling method (1000 iterations). Model performance was assessed through receiver operating characteristic (ROC) curve analysis, calibration curve analysis, and decision curve analysis (DCA).</p><p><strong>Results: </strong>This analysis revealed seven risk factors for ISR: diabetes (OR=1.380, 95% CI: 1.090-1.747), neutrophil/lymphocyte ratio (NLR, OR=2.312, 95% CI: 1.830-2.922), low-density lipoprotein (LDL) > 1.8 mmol/L (OR=2.159, 95% CI: 1.080-4.315), calcified lesions (OR=3.780, 95% CI: 2.051-6.968), stent diameter <3 mm (OR=2.595, 95% CI: 1.404-4.796), smoking (OR=2.796, 95% CI: 1.511-5.174) and no intravascular ultrasound (IVUS) assisted (OR=2.176, 95% CI: 1.342~3.257). These seven factors were incorporated into the nomogram model. The model demonstrated excellent discriminative ability, with an area under the curve (AUC) of 0.892 (95% CI: 0.859-0.924) and a consistency index (C-index) of 0.923. Calibration analysis showed close agreement between predicted and observed outcomes, while DCA indicated strong clinical utility across a wide probability threshold range (5.0%-86.2%). The relative importance of the risk factors, ranked in descending order, was as follows: calcified lesions, stent diameter <3 mm, no IVUS assisted, LDL>1.8 mmol/L, smoking, NLR and diabetes.</p><p><strong>Conclusion: </strong>The study identifies several risk factors for ISR in CHD patients within one year after PCI. The constructed nomogram model has good predictive efficiency and clinical applicability.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"18 ","pages":"2627-2637"},"PeriodicalIF":2.0,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12356208/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144876915","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":"Assessing Vaccination Coverage Among Healthcare Workers in Primary Healthcare Facility in Najran City, Saudi Arabia.","authors":"Nasser Saeed Alqahtani","doi":"10.2147/RMHP.S532849","DOIUrl":"10.2147/RMHP.S532849","url":null,"abstract":"<p><strong>Background and objective: </strong>Insufficient vaccination coverage among healthcare workers (HCWs) contributes to nosocomial outbreaks and avoidable deaths. This study assesses vaccine hesitancy among HCWs in primary healthcare facilities and identifies contributing factors in Najran City, Saudi Arabia.</p><p><strong>Methods: </strong>A cross-sectional study was conducted in August 2023 among healthcare workers (HCWs) at various healthcare facilities providing primary care. The study utilized a questionnaire developed in accordance with World Health Organization` (WHO) and Centers for Disease Control and Prevention (CDC) guidelines, covering sociodemographic and medical characteristics, vaccination profiles (19 items), and evidence of vaccination status. A multistage sampling technique was employed to obtain a representative sample, involving random selection of HCWs from various categories (physicians, pharmacists, dentists, nurses, laboratory technicians, radiology technicians, and paramedics) and clustering willing participants from each facility type.</p><p><strong>Results: </strong>Among the 591 healthcare workers (HCWs), 57.7% were male and 45.8% were aged 31-40 years. Vaccination compliance rates varied, with the highest rates observed for the third COVID-19 dose (86.3%), hepatitis B (81.2%), and influenza (78.3%), while the lowest rate was for Tdap during pregnancy (27.7%). Immunization documentation was primarily evidenced through vaccine records (67.5%), lab tests (51.8%), and disease confirmation (36.9%). In this study 70.9% partially, 19.1% fully vaccinated, and 10% unvaccinated. Regarding immunization documentation, 57% was partial, 15.7% complete, and 27.2% incomplete. Significant predictors of being unvaccinated included male sex (p=0.001), Saudi nationality (p=0.030), and technician/paramedic profession (p<0.001). Additionally, HCWs experiencing burnout were more likely to be unvaccinated (p=0.006). Multivariate analysis revealed that technicians/paramedics were 2.74 times more likely to be unvaccinated than physicians (AOR=2.743; 95% CI=1.140-6.600; p=0.024).</p><p><strong>Conclusion: </strong>This study highlights significant gaps in vaccination coverage among HCWs, working at primary healthcare facilities with only 19.1% fully vaccinated. Factors such as male gender and burnout contribute to vaccine hesitancy. To address these gaps, future directions such as targeted educational interventions, burnout mitigation, mobile vaccination units, and awareness campaigns are recommended. Additionally, supportive measures to manage burnout are crucial for improving vaccination rates and protecting public health.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"18 ","pages":"2613-2625"},"PeriodicalIF":2.0,"publicationDate":"2025-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12354978/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144876914","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}