Risk Management and Healthcare Policy最新文献

{"title":"Accuracy of Caregiver-Reported Height, Weight, and BMI in a Pediatric Growth Clinic.","authors":"Qian Zhang, Nai-Jun Wan","doi":"10.2147/RMHP.S529963","DOIUrl":"10.2147/RMHP.S529963","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the accuracy of caregiver-reported height, weight, and body mass index (BMI) in children attending a pediatric growth clinic, and to explore the impact of these errors on clinical management and telemedicine.</p><p><strong>Methods: </strong>This cross-sectional study included 132 children aged 6-12 years attending a pediatric growth clinic. Caregivers reported their children's height and weight, and standard measurements were taken within one week. BMI was calculated for both sets of data. Differences between caregiver-reported and standard measurements were analyzed across gender and age. Bland-Altman and linear regression analyses assessed agreement and correlation.</p><p><strong>Results: </strong>Caregivers slightly overestimated height (+0.6 cm) and underestimated weight (-0.9 kg), resulting in an underestimation of BMI (-0.6 kg/m², p < 0.001). About 4.5% of overweight children were misclassified as non-overweight. Measurement errors showed no significant differences by gender or age group. Most caregivers measured their children's height and weight approximately once per month, regardless of subgroup. Despite minor discrepancies, caregiver-reported and standard data were strongly correlated <i>(R²</i> > 0.9). Bland-Altman analysis revealed good agreement, though height had slightly lower concordance.</p><p><strong>Conclusion: </strong>While caregiver-reported measurements exhibited minor errors, the magnitude was comparable to previous findings in general pediatric populations. Thus, caregiver-reported data may be suitable for follow-up monitoring in pediatric growth clinics but should be used cautiously for initial diagnosis or therapeutic decisions.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"18 ","pages":"2591-2600"},"PeriodicalIF":2.0,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12343336/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144849701","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":"Anxiety and Depressive Symptoms Among Kidney Transplant Recipients in Post-COVID-19 China: Prevalence and Risk Factors.","authors":"Hong Zhang, Sai Zhang, Miao Zhou, Chunmi Geng, Xiang Ding","doi":"10.2147/RMHP.S529124","DOIUrl":"10.2147/RMHP.S529124","url":null,"abstract":"<p><strong>Background: </strong>Anxiety and depression are highly prevalent and disabling mental disorders that often coexist. Kidney transplant recipients are at high risk of anxiety and depression, especially during the COVID-19 pandemic. However, studies focusing on depression and anxiety among kidney transplant recipients in the post-COVID-19 era are lacking.</p><p><strong>Objective: </strong>The primary objective of this study was to analyze the prevalence of anxiety symptoms alone (ASA), depressive symptoms alone (DSA), and comorbid anxiety and depressive symptoms (CADS) in kidney transplant recipients after the COVID-19 pandemic. The secondary objective was to identify the risk factors associated with these symptoms.</p><p><strong>Methods: </strong>A cross-sectional survey was conducted among kidney transplant recipients in a tertiary hospital in Hunan, China, from December 2022 to December 2023. A total of 520 recipients were invited to participate in the survey, and 517 valid questionnaires were obtained (response rate 99.4%). Anxiety and depressive symptoms were assessed using the Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS), based on which participants were divided into four groups: normal (no anxiety or depressive symptoms), ASA, DSA, and CADS. Clinical characteristics were compared between the groups, and the risk factors associated with ASA, DSA, and CADS were analyzed using multiple logistic regression.</p><p><strong>Results: </strong>Among the 517 kidney transplant recipients enrolled ASA was identified in 3.7% of recipients (n=19), DSA in 20.3% (n=105), and CADS in 13.9% (n=72). Multiple logistic regression showed that rejection was positively associated with ASA, and vaccination was negatively associated with DSA. Younger age, transplant nephritis/nephropathy, a history of postoperative pulmonary infection, and rejection were positively associated with CADS.</p><p><strong>Conclusion: </strong>In the post-COVID-19 era, our study identifies a high prevalence of anxiety and depressive symptoms among kidney transplant recipients, with multiple associated factors. These findings highlight the urgent need for systematic mental health screening and the development of targeted psychological interventions in transplant care.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"18 ","pages":"2601-2611"},"PeriodicalIF":2.0,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12341563/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144838675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How DRG Payment Reform Shapes Inpatient Neurological Care in an Underdeveloped Region: Evidence from a Controlled Interrupted Time Series Study in Yunnan, China.","authors":"Sixian Du, Yaqing Liu, Chengfeng Yang, Yong Yang, Yiqing Yang","doi":"10.2147/RMHP.S530693","DOIUrl":"10.2147/RMHP.S530693","url":null,"abstract":"<p><strong>Background: </strong>This study evaluates the impact of the DRG-based payment reform pilot, initiated in January 2023, in an underdeveloped city in Southwest China. The reform's implications are particularly relevant for resource-limited settings, where healthcare cost control and service efficiency are critical for improving patient care.</p><p><strong>Purpose: </strong>This study aims to evaluate the impact of this reform on the inpatient service capacity, cost, and efficiency of the Neurology Department in the leading hospital within a county-level medical community.</p><p><strong>Material and methods: </strong>We conducted a controlled interrupted time series (ITS) analysis using monthly administrative data from January 2021 to June 2024, focusing on inpatients treated in the Neurology Department of M Hospital, A City, Yunnan Province. Eleven outcome indicators were assessed, including Total DRG Weight, Case Mix Index (CMI), Average Length of Stay (ALOS), and Average Inpatient Cost (measured in Renminbi, RMB). A comparable control group was used to strengthen causal inference.</p><p><strong>Results: </strong>Following the DRG reform, the Neurology Department experienced a 32.37% increase in Total DRG Weight, a 12.21% rise in CMI, and an 8.94% increase in the number of DRG groups, while ALOS decreased by 9.85%. The ITS model revealed a significant upward trend in Total DRG Weight (trend change = 2.16, <i>P</i> < 0.01) and a downward trend in ALOS (trend change = -0.04, <i>P</i> < 0.01). Additionally, the average inpatient cost declined significantly, with a trend reduction of 121.65 RMB per month (<i>P</i> < 0.01).</p><p><strong>Conclusion: </strong>The implementation of DRG-based payment reform in A City was associated with enhanced inpatient service efficiency in the Neurology Department, including improved case complexity management, shorter hospital stays, and reduced costs. However, medical equipment-related expenses remained unaffected, potentially due to increasing patient severity and ongoing technology investments. These findings offer valuable evidence for policymakers aiming to optimize hospital performance through payment system reform in resource-limited settings.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"18 ","pages":"2575-2590"},"PeriodicalIF":2.0,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12344135/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144849702","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":"Airway Management Following Head and Neck Microvascular Reconstruction: When is a Tracheostomy Necessary?","authors":"Pao-Jen Kuo, Pi-Chieh Lin, Ching-Hua Hsieh","doi":"10.2147/RMHP.S538063","DOIUrl":"10.2147/RMHP.S538063","url":null,"abstract":"<p><p>Head and neck free flap reconstruction presents complex airway challenges due to postoperative swelling, bleeding, and anatomical distortion that can jeopardize breathing. Many centers once performed routine prophylactic tracheostomy for major cases, yet modern evidence favors a selective strategy. Avoiding an unnecessary tracheostomy when feasible can reduce morbidity, shorten hospital stay, accelerate return to oral intake, and lower cost. Contemporary practice relies on careful intraoperative assessment. Low-risk patients can be extubated immediately or after brief observation, whereas high-risk features-extensive tongue or base of tongue resection, bilateral neck dissection, bulky flap, or marked edema-mandate a tracheostomy to avert obstruction. There is new update to TRACHY (an acronym that represents Tumor extent, Reconstruction type, Airway anatomy, Coexisting conditions, History of prior treatment, and bilateral neck dissection \"lateralitY\") scoring systems and risk stratification tools, which assign risk points to support decisions. Once a tracheostomy is placed, decannulation proceeds when airway patency is secure, the patient is alert with a strong cough, the surgical site is stable, swallowing is safe or alternative feeding is available, capping trials are successful, and the multidisciplinary team agrees. A tailored approach therefore balances airway safety with the benefits of tracheostomy avoidance, optimizing outcomes for patients undergoing complex head and neck reconstruction.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"18 ","pages":"2551-2563"},"PeriodicalIF":2.0,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12335268/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144818383","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":"Addressing the Unmet Educational Needs of Students with Epidermolysis Bullosa in Saudi Arabia.","authors":"Ashjan Alheggi, Reem Bin Shlhoob, Raghad Alharthi, Abrar Bukhari, Rayan Alkhodair","doi":"10.2147/RMHP.S512984","DOIUrl":"10.2147/RMHP.S512984","url":null,"abstract":"<p><strong>Purpose: </strong>Epidermolysis bullosa (EB) is a rare genodermatosis characterized by fragility and blistering of the skin and mucous membranes following minor trauma. Attending school presents unique educational and psychosocial challenges for students with EB. This study aimed to investigate perceptions of school climate and educational experiences among students with EB in Saudi Arabia.</p><p><strong>Methods: </strong>A cross-sectional observational study was conducted involving students with EB, aged 3-22 years, recruited from the Saudi EB registry. Data were collected using a self-reported 23-item multidimensional questionnaire assessing physical, psychological, social, financial, and learning domains. Data were collected from January 2024 to April 2024. Descriptive and inferential statistical analyses were performed using SPSS software.</p><p><strong>Results: </strong>Thirty-one students with EB were enrolled in this study. The EB subtypes were as follows: EB simplex (n=10), junctional EB (n=7), dystrophic EB (n=11), Kindler EB (n=1), and two patients with unknown types. Participants had an overall negative perception of school climate (mean, 58.5±14.3). A significant proportion of students experienced delayed entry into elementary school due to EB (41.9%). Students with junctional EB, those in high school, late-entry grade 1 students, and those from low-income families reported more negative perceptions of the school climate. Key challenges included difficulty in physical education classes, stigmatization, bullying, social isolation, and chronic wound-related pain and itching. Frequent absences were reported by 51.6% of the students. Homeschooled students demonstrated better learning scores than those attending traditional schools. Students with severe EB subtypes (junctional and dystrophic EB) demonstrated a higher preference for homeschooling.</p><p><strong>Conclusion: </strong>This study highlights the unmet needs of students with EB and provides insights into recommendations to enhance their adjustment in schools. Students with EB face substantial educational and psychosocial challenges. Tailored accommodations are needed to promote inclusion and improve school experiences for this population.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"18 ","pages":"2565-2573"},"PeriodicalIF":2.0,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12335246/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144818382","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":"Risk Prediction of Postoperative Renal Dysfunction Based on Preoperative Lipid Profiles in Renal Transplant Recipients: A Retrospective Cohort Study.","authors":"Hong Zhang, Haoxiang Zhang, Ronghua Li, Lin Zhuo, Ling Liu, Ling Tan, Rongrong Li, Sai Zhang","doi":"10.2147/RMHP.S527703","DOIUrl":"10.2147/RMHP.S527703","url":null,"abstract":"<p><strong>Introduction: </strong>Renal transplant recipients (RTRs) are at high risk of renal dysfunction, and one contributing factor may be abnormal blood lipids. This study aimed to establish a risk prediction model using machine learning (ML).</p><p><strong>Methods: </strong>This retrospective cohort study recruited 345 RTRs and followed up for one year. Patients' demographic and clinical characteristics were retrieved from the electronic medical record system. The cohort was randomly split into training (n = 276) and validation (n = 69) groups at a 4:1 ratio. Predictors of renal dysfunction were determined using three ML models: RandomForest, XGBoost, and LightGBM.</p><p><strong>Results: </strong>During the one-year follow-up, 193 (55.9%) patients developed renal dysfunction. Among 20 demographic and clinical variables screened, five were identified as significant predictors: age, gender, HDL-C, non-HDL-C, and LDL-C. A nomogram was developed as a visual predictive tool to present the interplay between these variables graphically. It demonstrated good diagnostic performance, with an area under the curve (AUC) of 0.87 (95% CI, 0.85-0.89) in the training group and 0.81 (95% CI, 0.78-0.83) in the validation group.</p><p><strong>Conclusion: </strong>Our study developed a risk prediction model to identify RTRs at high risk of renal dysfunction based on preoperative lipid profiles, which is crucial for optimizing patient management and improving the prognosis.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"18 ","pages":"2539-2550"},"PeriodicalIF":2.0,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12335256/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144818384","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":"Knowledge, Attitude and Practices of Abattoir Workers Towards Waste Management in Slaughterhouses in Kampala City, Uganda.","authors":"John Paul Sserubula, Pius Jemba, Robert Twinamatsiko","doi":"10.2147/RMHP.S517421","DOIUrl":"10.2147/RMHP.S517421","url":null,"abstract":"<p><strong>Background: </strong>The effective management of abattoir waste is crucial for environmental protection and public health. The existing poor waste management and related effects can be caused by insufficient knowledge and bad attitudes of the stakeholders involved in abattoir operations. This study evaluated the knowledge, attitudes, and practices of abattoir workers regarding waste management in the Wambizzi and Kalerwe abattoirs in Kampala, Uganda.</p><p><strong>Methods: </strong>A mixed method cross-sectional design utilising qualitative and quantitative methods. The data collection involved questionnaires among 250 workers, 2 observational checklists, 12 key informant interviewees (KIIs), and 8 focus group discussion groups (FGDs). Study participants for quantitative research were recruited using a stratified random sampling technique and data analysed descriptively while purposive sampling was used for KIIs and FGDs and data analysed thematically.</p><p><strong>Results: </strong>The study found that 71.6% of workers had good knowledge of abattoir waste management, although gaps in waste sorting were identified. Additionally, 71.2% of workers had positive attitudes towards waste management. However, challenges, such as inadequate infrastructure, poor abattoir design, and inconsistent waste collection, are prevalent. Despite these challenges, the workers demonstrated good practices, with 50.4% exhibiting effective waste management. From qualitative findings, existence of internal rules and regulations on waste management with penalties and punishments was also responsible for abattoir workers' practices towards abattoir waste management.</p><p><strong>Conclusion and recommendations: </strong>This study highlights the need for improved waste sorting knowledge, enhanced infrastructure, and logistical support since there was a disconnect between survey results and actual practices. Future research should explore the impact of long-term benefits of infrastructure improvements on waste management efficiency. These findings underscore the importance of addressing both knowledge and practical challenges in achieving sustainable waste management in abattoirs.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"18 ","pages":"2517-2527"},"PeriodicalIF":2.0,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12325110/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144796243","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":"Assessment of Hand Hygiene Knowledge, Attitude, and Practice Among Health Sciences Students in Herat, Afghanistan: A Cross-Sectional Study [Letter].","authors":"Sanjay Shinde, Rafia Islam, Augustine Suglo Dakurah","doi":"10.2147/RMHP.S551837","DOIUrl":"10.2147/RMHP.S551837","url":null,"abstract":"","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"18 ","pages":"2515-2516"},"PeriodicalIF":2.0,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12325109/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144796197","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":"Engaging Essential Patient Support Personnel in Research as Patient Partners: A Survey Study.","authors":"Christine Skubisz, Shayna DeRosa, Carly R Pacanowski","doi":"10.2147/RMHP.S512398","DOIUrl":"10.2147/RMHP.S512398","url":null,"abstract":"<p><strong>Introduction: </strong>Patient engagement in research is a collaborative interaction between patients and researchers throughout the entire research process. Healthcare workers provide care for others, but are the patients themselves in areas of workplace safety and mental health. Essential patient support personnel working on the front line of healthcare are particularly vulnerable but have an underrepresented voice in the research conducted about their health and work.</p><p><strong>Methods: </strong>To explore this topic, a survey study of essential patient support personnel (N=42), guided by the Integrated Model of Behavioral Prediction, measured attitudes about engagement, behavioral intentions, and past engagement behavior. Skills and constraints, predictors of behavioral intentions for engagement in the model, were also assessed.</p><p><strong>Results: </strong>Results showed that essential patient support personnel had positive attitudes and positive behavioral intentions to engage in research, yet only two participants had engaged in research in the past. Participants reported the most positive behavioral intentions to contribute at the preparation stage of research. Overwhelmingly, participants reported that the most important skill essential patient support personnel bring to a research team is their first-hand experience. Significant constraints to engagement included a lack of time, insufficient compensation, and job burnout.</p><p><strong>Conclusion: </strong>Efforts to bolster patient engagement in research should focus on increasing the skills necessary for study execution (eg, study design and data analysis) and removing constraints to contribution (eg, providing appropriate monetary compensation, being mindful of time and heavy work schedules).</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"18 ","pages":"2529-2537"},"PeriodicalIF":2.0,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12325099/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144796198","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":"Midwives' Experiences of Caring for Ukrainian War Refugees: A Qualitative Study.","authors":"Katarzyna Leoniuk, Krzysztof Sobczak, Weronika Kamińska-Skrzyńska, Agata Janaszczyk","doi":"10.2147/RMHP.S524572","DOIUrl":"10.2147/RMHP.S524572","url":null,"abstract":"<p><strong>Purpose: </strong>The outbreak of the war in Ukraine resulted in an increased number of war refugees giving birth in Polish hospitals. The aim of the study was to analyze the experiences of midwives providing perinatal care to war refugees. Additionally, the study aimed to design systemic recommendations to improve the quality of intercultural care.</p><p><strong>Patients and methods: </strong>The research was conducted using the qualitative method with the online Semi-Structured Interview technique. When structuring the data, the COREQ standard was chosen in accordance with EQUATOR recommendations. The analysis included interviews with 16 professionally active midwives providing perinatal care in Polish hospitals.</p><p><strong>Results: </strong>In the study, midwives indicated four types of barriers in the care of war refugees from Ukraine. These includes: language barriers (n=16), cultural barriers (n=8), educational barriers (n=5) and psychological barriers (n=3). Fifteen respondents indicated the occurrence of differences in the care of Ukrainian women giving birth. The dissimilarities were related to the level of cultural differences (tradition; n=15), differences in accommodation (withdrawal, passivity, alienation; n=15) and in assimilation (instrumental acculturation, informational reorientation; n=11).</p><p><strong>Conclusion: </strong>The obstetric staff notices differences in care, and identifies barriers that affect the quality of medical services provided to war refugees. The analysis of midwives' statements contributed to the creation of a theoretical concept - a differences in care pyramid. Development of a systemic solution that minimizes the effects of the language barrier is crucial. Moreover, it is important to implement information actions that raise the level of knowledge about the functioning of the health care system in Poland, and prenatal education dedicated to war refugees.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"18 ","pages":"2505-2514"},"PeriodicalIF":2.0,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12315856/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144777009","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}