Risk Management and Healthcare Policy最新文献

{"title":"Clinical Characteristics and Prognostic Factors of Patients with Acute Poisoning: A Retrospective Observational Cohort Study of Diquat, Single-Drug and Mixed-Drug Exposures.","authors":"Hongyu Han, Lihua Gao, Han Cui, Dan Li, Yanan Hou, Jing Jiang, Hongna Sun","doi":"10.2147/RMHP.S596229","DOIUrl":"10.2147/RMHP.S596229","url":null,"abstract":"<p><strong>Background: </strong>Acute poisoning remains a major emergency and toxicology problem, but its clinical pattern differs by toxin type and local availability. Diquat poisoning is increasingly reported where paraquat use has been restricted, whereas metamizole exposure remains relevant in regions where dipyrone remains clinically available.</p><p><strong>Objective: </strong>This retrospective observational cohort study described clinical characteristics, treatment patterns and prognostic factors in acute poisoning involving diquat, single-drug pharmaceutical exposure and mixed-drug exposure.</p><p><strong>Methods: </strong>We analysed 385 adults with confirmed acute poisoning treated at a single tertiary toxicology centre from January to June 2025. Patients were classified as Group A (diquat, n = 125), Group B (single-drug poisoning, predominantly metamizole, n = 143) or Group C (mixed-drug poisoning, n = 117). Baseline features, laboratory findings, interventions and 30-day outcomes were compared. A presentation-based logistic regression model assessed mortality predictors, and early haemoperfusion was analysed separately in the diquat subgroup.</p><p><strong>Results: </strong>Group A had the highest 30-day mortality (28.8%) compared with Group B (5.6%) and Group C (14.5%) (p < 0.001). Liver injury, renal dysfunction, cardiac biomarker elevation, lactate elevation and acidosis were most pronounced after diquat exposure. In the diquat subgroup, haemoperfusion within 6 hours was associated with lower mortality than delayed haemoperfusion (17.1% vs 47.6%, p < 0.001), including after propensity score matching. Diquat poisoning, delayed presentation, low Glasgow Coma Scale score, hypotension, elevated lactate, renal dysfunction, acidosis and early multi-organ dysfunction were associated with mortality.</p><p><strong>Conclusion: </strong>Acute poisoning showed heterogeneous clinical patterns by toxic agent category. Diquat poisoning carried the greatest mortality and multi-organ injury, whereas mixed-drug poisoning showed intermediate severity. Early haemoperfusion was associated with improved outcomes in diquat poisoning, but causal interpretation is limited by the retrospective design; prospective multicentre validation is needed.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"19 ","pages":"596229"},"PeriodicalIF":2.6,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13384098/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148609899","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 Simplified Nomogram for Primary Population-Based Screening of Esophageal Cancer: An Internally Validated Shandong Cohort Study Addressing Data Imbalance.","authors":"Junjun Hou, Xiuyu He, Fei Gao, Ting Ren, Lijin Ren, Xianguo Wang","doi":"10.2147/RMHP.S607198","DOIUrl":"10.2147/RMHP.S607198","url":null,"abstract":"<p><strong>Objective: </strong>To develop and validate a user-friendly nomogram for predicting the risk of esophageal squamous cell carcinoma (ESCC) and high-grade intraepithelial neoplasia (HGIN), designed for initial screening settings while addressing variable complexity and class imbalance in traditional models.</p><p><strong>Methods: </strong>Based on a screening cohort of 23,257 participants from Tai'an, Shandong, between 2024 and 2025 (positive rate: 1.54%), a 1:10 case-control sampling method was applied to address the low event rate (positive rate: 1.54%) and correct class imbalance. Predictors were initially screened using LASSO regression with 10-fold cross-validation (λ.min criterion) and further refined via multivariable logistic regression to establish the final model, which was presented as a nomogram and evaluated via internal split-sample validation.</p><p><strong>Results: </strong>Seven easily accessible predictors were identified: age, sex, education level, BMI, smoking history, hot-food consumption, and family history of esophageal cancer. The model showed strong discriminatory performance, with an AUC of 0.823 (95% CI: 0.798-0.848) in the training set and 0.835 (95% CI: 0.805-0.865) in the internal validation set. Calibration curves indicated high consistency between predicted and observed risks. Decision curve analysis demonstrated net clinical benefit across risk thresholds of 0-0.6.</p><p><strong>Conclusion: </strong>The proposed simplified nomogram demonstrates promising potential for risk stratification in primary ESCC/HGIN screening. However, prospective external validation in diverse cohorts is necessary before its large-scale clinical implementation.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"19 ","pages":"607198"},"PeriodicalIF":2.6,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13388748/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148563897","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":"Feasibility-First Risk Management for Clinical AI: A Deterministic Systems Intelligence Framework for Release, Monitoring, Rollback and Withholding.","authors":"Adegoke O Adefolalu","doi":"10.2147/RMHP.S621924","DOIUrl":"10.2147/RMHP.S621924","url":null,"abstract":"<p><p>Artificial intelligence (AI) is increasingly used to predict deterioration, classify risk, prioritise workload, support diagnosis, tailor communication and monitor patients across healthcare settings. Existing safety discussions rightly emphasise model performance, bias, explainability, regulatory approval and post-deployment monitoring. However, these domains do not fully answer a prior risk-management question: when should an AI output be released into clinical or organisational action under the active healthcare regime? This Perspective develops a Deterministic Systems Intelligence (DSI) framework for feasibility-first clinical AI risk management. The proposed admissible-state layer evaluates candidate AI outputs against data fitness, population fit, clinical actionability, workflow capacity, equity, authority, monitoring and reversibility before action is permitted. It classifies outputs into five governance states: release, restricted release, active monitoring, rollback and HOLD. HOLD denotes disciplined non-release when evidence, feasibility or safeguards are insufficient. A worked deterioration-alert example shows how the same technically plausible output may be released, restricted, monitored, rolled back or held depending on local capacity, equity and safety controls. The framework complements reporting, audit, regulatory and algorithmovigilance approaches by inserting an explicit admissibility step between AI output and healthcare action. Responsible clinical AI therefore requires not only prediction, but release readiness, monitoring and the capacity to withhold.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"19 ","pages":"621924"},"PeriodicalIF":2.6,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13384092/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148610055","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":"Feasibility of Home-Based Electromagnetic Navigation-Guided Nasojejunal Tube Placement in a High-Risk Bedridden Elderly: A Case Report.","authors":"Ningxuan Liu, Meng Hong","doi":"10.2147/RMHP.S599330","DOIUrl":"10.2147/RMHP.S599330","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the feasibility and clinical outcomes of a nurse‑performed, home‑based electromagnetic navigation‑guided nasojejunal tube placement in a high‑risk bedridden elderly patient who was unable to be transported to hospital.</p><p><strong>Methods: </strong>We present a case of an 89-year-old male with long-term bedridden status and high aspiration risk. A qualified nurse performed electromagnetic navigation-guided nasojejunal tube insertion in the patient's home environment. The procedure steps, nursing interventions, and short-term outcomes were documented.</p><p><strong>Results: </strong>The tube was successfully placed in the upper jejunum under real-time electromagnetic guidance within 8 minutes. No complications such as tube displacement, blockage, or aspiration occurred during the 15-day follow-up. Family satisfaction was high.</p><p><strong>Conclusion: </strong>This first reported case suggests that nurse-led, home-based electromagnetic navigation-guided nasojejunal tube placement may be a feasible and safe option for high-risk bedridden elderly patients who cannot be transported. Strict environmental assessment, operator expertise, and structured risk management are essential for success.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"19 ","pages":"599330"},"PeriodicalIF":2.6,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13380910/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148521576","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":"Family-Centered Psychosocial Interventions for Disaster-Affected Children Across Developmental Stages: A Scoping Review.","authors":"Putri Rhamelani, Annisa Putri Cahaya, Sri Yunita, Restu Wijayanti, Jelita Puspa Nirwana, Nando Nasution, Aninda Widiawati, Rima Oktaviani, Yunihar Susilawaty Sijabat, Nurul Febrian, Rahayu Rahayu, Onis Rohnenti, Ayu Prawesti Priambodo","doi":"10.2147/RMHP.S622846","DOIUrl":"10.2147/RMHP.S622846","url":null,"abstract":"<p><p>Children are highly vulnerable in disaster settings due to developmental, physiological, and psychosocial limitations, increasing their risk of long-term mental health and psychosocial problems. Although disasters cause both physical and psychological consequences, psychosocial difficulties often persist longer and may hinder children's developmental recovery. Therefore, family-centered psychosocial interventions are essential for post-disaster recovery. However, the integration of Family-Centered Care (FCC) principles into disaster mental health and psychosocial support systems remains fragmented and insufficiently tailored to children's developmental stages. This scoping review mapped and synthesized evidence on family-centered psychosocial interventions for disaster-affected children across developmental stages. Following PRISMA-ScR guidelines, articles published between 2016 and 2026 were searched in PubMed, MEDLINE, Scopus, ScienceDirect, and SAGE. Studies were selected using PCC criteria (Population: children aged 0-18 years; Concept: family-centered psychosocial interventions, including caregiver-mediated, play-based, cognitive-behavioral, resilience-building, and family support approaches; Context: disaster settings). Eleven studies (randomized controlled trials, quasi-experimental, and mixed-methods) from multiple countries were included. Findings indicate that interventions are developmentally differentiated and predominantly family-based; however, evidence remains limited for preschool children, adolescents, and long-term psychosocial outcomes. Play-based and dyadic caregiver child interventions were primarily used for younger children, while cognitive behavioral and resilience-focused approaches were more common among school-aged children and adolescents. Across studies, improvements in caregiver wellbeing and family functioning were consistently associated with better child emotional and behavioral outcomes, highlighting an interconnected recovery pathway across developmental stages. Family-centered psychosocial interventions should be tailored to developmental needs and strengthen caregiver wellbeing and family functioning. The findings support integrating family-centered approaches into disaster mental health systems to strengthen resilience and long-term recovery, particularly in disaster-prone and resource-limited settings.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"19 ","pages":"622846"},"PeriodicalIF":2.6,"publicationDate":"2026-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13371866/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148457826","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":"Trends and Drivers of Head and Neck Cancers in Older Adults Over 30 Years: A Population-Based Modelling Study.","authors":"Yi-Pin Yang, Ya-Fen Wang, Fen-Fen Li, Yu-Han Liu, Bing-Yu Liang, Yan-Xun Han, Yu-Chen Liu, Ye-Hai Liu, Liang Zhang","doi":"10.2147/RMHP.S615960","DOIUrl":"10.2147/RMHP.S615960","url":null,"abstract":"<p><strong>Background: </strong>Head and neck cancers (HNCs) are a significant source of morbidity and contribute to severe functional impairments in older adults globally. Although largely preventable, inadequate mapping of their long-term epidemiological trends and determinants hinders the development of targeted prevention and rehabilitation strategies.</p><p><strong>Methods: </strong>This study analyzed the global incidence and mortality of major HNCs, including nasopharyngeal cancer (NPC), lip and oral cavity cancer (LOCC), other pharyngeal cancer (OPC), and laryngeal cancer (LC) in older adults (60-89 years) from 1992 to 2021. Their temporal and future trends were assessed using Joinpoint regression BAPC models, respectively.</p><p><strong>Results: </strong>Globally, 464,744 new cases and 303,207 deaths were reported among older adults in 2021. The long-term trends from 1992 to 2021 showed a slight increase in the age-standardized incidence rate (ASIR) and a significant decrease in the age-standardized mortality rate (ASMR). The global ASIR and ASMR for LOCC and OPC increased from 1992 to 2021. However, those for NPC and LC decreased. LOCC and LC were the most prevalent HNCs among older adults globally, followed by OPC and NPC. However, the burden of the four cancers varied across regions. The numbers of cases and deaths from the four HNCs are projected to continue increasing.</p><p><strong>Conclusion: </strong>The global burden of head and neck cancers in older adults is increasing due to population growth and aging. This trend, particularly the notable rise in OPC, poses a significant challenge for countries with high and low-middle sociodemographic index scores, especially those in America and Europe. Tobacco and alcohol use remain the dominant modifiable risk factors. Addressing these factors is critical to reducing severe swallowing and communication impairments and mitigating the disproportionate burden borne by older adults.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"19 ","pages":"615960"},"PeriodicalIF":2.6,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13367473/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148450604","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":"Beyond Compliance: An HRO-Based Governance Framework for ISO 45001-Enabled Safety Strategy in Healthcare.","authors":"Bandar Saad Alshreef","doi":"10.2147/RMHP.S604364","DOIUrl":"10.2147/RMHP.S604364","url":null,"abstract":"<p><strong>Purpose: </strong>This paper proposes a conceptual framework to reposition the ISO 45001 standard from a compliance-driven tool to a strategic governance framework for improving occupational health and safety (OHS) in healthcare.</p><p><strong>Design/methodology/approach: </strong>This is a conceptual paper that synthesizes existing literature from management, safety science, and healthcare. It does not present new empirical data but develops a new theoretical lens for understanding and applying ISO 45001.</p><p><strong>Findings: </strong>The compliance-oriented approach to ISO 45001 in healthcare fosters audit-driven behavior and weakens sustainable safety culture. We propose a three-layer governance framework-(1) Foundational governance infrastructure (ISO 45001 Clauses 4-10), (2) Strategic integration mechanisms (leadership accountability, worker participation, integrated risk governance), and (3) Strategic outcomes (safety culture maturity, workforce well-being, patient safety, and organizational resilience)-that operationalizes High-Reliability Organization (HRO) principles through auditable governance mechanisms.</p><p><strong>Originality/value: </strong>The paper's novelty lies in offering a practical, theoretically grounded model that bridges the gap between OHS management and strategic governance in healthcare. It provides a roadmap for moving beyond certification to unlock the standard's potential for enhancing workforce well-being, patient safety, and organizational resilience.</p><p><strong>Practical implications: </strong>The framework offers healthcare leaders, regulators, and accreditation bodies a new way to think about and implement ISO 45001. It provides concrete examples of how to integrate OHS into existing governance structures, address common critiques, and measure the strategic value of safety investments.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"19 ","pages":"604364"},"PeriodicalIF":2.6,"publicationDate":"2026-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13361408/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148438969","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":"Barriers to Lean & Safety Management Implementation in Primary Care Settings: Insights from an Unsuccessful Case.","authors":"Anna Tiso, Caterina Pozzan, Chiara Pamich, Chiara Verbano","doi":"10.2147/RMHP.S610926","DOIUrl":"10.2147/RMHP.S610926","url":null,"abstract":"<p><strong>Background: </strong>Primary care is widely recognized as a cornerstone of universal health coverage, providing high-quality care in community-based settings. Structured managerial approaches such as Lean & Safety Management (L&SM) can support quality improvement in healthcare by reducing waste and risk and enhancing patient safety and satisfaction. However, evidence on the sustainable implementation of L&SM-defined as the ability to complete implementation and maintain improvements over time-remains limited in primary care. This study aims to identify key challenges affecting the sustainability of L&SM implementation in community healthcare centers.</p><p><strong>Methods: </strong>An unsuccessful L&SM implementation was analyzed through an in-depth case study of an Integrated Family Medicine Centre in Italy. The project, based on the DMAIC framework, was discontinued after the Define phase. A structured three-step methodology was adopted: 1) selection of a failed implementation case using predefined suitability criteria; 2) identification of implementation barriers through a systematic assessment of Critical Success Factors for sustainable Lean and Safety implementation adapted from the literature; and 3) validation of findings and exploration of corrective actions through a stakeholders focus group.</p><p><strong>Results: </strong>The analysis identified multiple barriers that contributed to implementation failure. These barriers were synthesized into three interrelated themes: organizational readiness, stakeholder ownership and engagement, and governance fragmentation. Together, these factors limited coordination, reduced commitment to improvement activities, and hindered the sustainability of the implementation process.</p><p><strong>Conclusion: </strong>Sustainable L&SM implementation in primary care requires organizational readiness, committed leadership, stakeholder engagement, adequate training, and robust data infrastructure. Addressing these factors may improve the successful adoption and long-term sustainability of quality improvement initiatives in community-based settings.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"19 ","pages":"610926"},"PeriodicalIF":2.6,"publicationDate":"2026-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13361523/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148438912","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":"Cardiovascular Mortality in Amyloidosis: Long-Term Trends, Disparities, and Projections in the United States.","authors":"Zhan Chen, Ying Tian, Yue Zhang","doi":"10.2147/RMHP.S607682","DOIUrl":"10.2147/RMHP.S607682","url":null,"abstract":"<p><strong>Background: </strong>Cardiac involvement is a major determinant of prognosis in systemic amyloidosis, but population-level trends in cardiovascular mortality remain insufficiently characterized.</p><p><strong>Methods: </strong>We performed a retrospective, population-based analysis of U.S. adults aged ≥45 years with amyloidosis using death certificate data from the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) database from 1999 through 2023. Cardiovascular disease (CVD)-related deaths were identified using ICD-10 codes and classified into heart failure (HF), atrial fibrillation/flutter (AF), ischemic heart disease (IHD), or other CVD categories. Age-adjusted mortality rates (AAMRs) were calculated using the 2000 U.S. standard population. Joinpoint regression assessed temporal trends, and autoregressive integrated moving average (ARIMA) models projected mortality through 2033.</p><p><strong>Results: </strong>A total of 35,222 CVD-related deaths occurred among adults with amyloidosis during the study period, yielding an overall AAMR of 1.12 per 100,000 population. Cardiovascular mortality increased nearly threefold, from 0.80 per 100,000 in 1999 to 2.27 per 100,000 in 2023, with a marked acceleration beginning in the late 2010s. HF consistently accounted for the largest proportion of CVD-related deaths. Mortality rates were higher among males, older adults, and non-Hispanic Black individuals, with demographic and geographic disparities widening over time. Similar upward trajectories were observed across U.S. Census regions and levels of urbanization. Projections indicated continued increases in cardiovascular mortality through 2033.</p><p><strong>Conclusion: </strong>Cardiovascular mortality among U.S. adults with amyloidosis has increased substantially over the past 25 years, with recent acceleration and persistent population-level disparities. These findings highlight a growing public health burden and support earlier detection, equitable access to specialized care, and continued national surveillance.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"19 ","pages":"607682"},"PeriodicalIF":2.6,"publicationDate":"2026-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13361406/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148439034","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":"Does Indemnity Private Insurance Increase Healthcare Utilization? Evidence from Korea's National Health Insurance System.","authors":"Hongki Gwak, Seong Hwan Kim","doi":"10.2147/RMHP.S607999","DOIUrl":"10.2147/RMHP.S607999","url":null,"abstract":"<p><strong>Purpose: </strong>South Korea's healthcare system is based on the National Health Insurance (NHI), and private insurance is commonly purchased to cover services not fully reimbursed by the NHI. Rising medical expenditures associated with indemnity-type private health insurance have become a growing policy concern.</p><p><strong>Patients and methods: </strong>In this cross-sectional study, adults aged <65 years without chronic diseases were selected from the Korea Health Panel Survey (2019-2020). Participants were classified into fixed-benefit or indemnity private insurance groups. Healthcare utilization and expenditures were compared, and multivariable regression models were used to evaluate factors associated with medical use and visit frequency.</p><p><strong>Results: </strong>A total of 3,320 participants were included in the analysis. The indemnity group showed higher outpatient care use than the fixed-benefit group, with mean outpatient visits of 9.14 versus 7.46 per year. There were no significant differences in expenditures for emergency or inpatient services. In the multivariable analysis, indemnity insurance was associated with higher outpatient care use (adjusted OR, 1.503; 95% CI, 1.232-1.834) and a higher number of outpatient visits (adjusted IRR, 1.167; 95% CI, 1.069-1.274).</p><p><strong>Conclusion: </strong>These findings suggest that indemnity-type private insurance is associated mainly with greater outpatient healthcare utilization and outpatient expenditures among adults without chronic diseases. The findings should be interpreted as outpatient-focused associations rather than evidence of broader system-wide cost effects.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"19 ","pages":"607999"},"PeriodicalIF":2.6,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13333070/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148392333","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}