Risk Management and Healthcare Policy最新文献

{"title":"Assessment of Dementia Patients Caregivers' Home Safety Knowledge in the Outpatient Setting of Jeddah, Saudi Arabia.","authors":"Asim Muhammed Alshanberi, Houriah Yasir Nukaly, Ahmed Hafez Mousa, Mahinar Mamdouh Alhartani, Jumanah Yaser Nassar, Ruqayyah Ali Ahmed, Terad Adnan Talmesany, Mohammed Shaikhomer, Ahmad A Imam, Ehab A Abo-Ali, Fatma E Hassan, Shakeel Ahmed Ansari","doi":"10.2147/RMHP.S604540","DOIUrl":"10.2147/RMHP.S604540","url":null,"abstract":"<p><strong>Background: </strong>Home safety is a major issue for individuals involved in caring for dementia patients due to a lack of practice and awareness, as it accounts for more than 90% of the needs of patients with dementia. Such caregivers face constant challenges in preventing accidents while trying to maintain the dementia patients' independence and quality of life.</p><p><strong>Objective: </strong>The objective of this unicentric study was to assess the correlates of dementia patients' caregivers' home safety practices.</p><p><strong>Methods: </strong>A cross-sectional study was conducted in an outpatient setting of a private hospital in Jeddah (Saudi Arabia) from November 2022 until January 2023 by assessing the possible correlation between the caregivers' demographics among 128 dementia patients' caregivers. It also evaluates their service experience including the type of care, assistance duration, duration of caregiving, average time spent with persons living with dementia, dementia care training experience and their home safety practice quality. A questionnaire utilizing selected items from the validated \"Alzheimer's Association Home Safety Checklist\" was employed to assess the caregivers' home safety practices. Besides, the caregivers' psychological well-being and depression were assessed through a validated \"Patient Health Questionnaire-2.</p><p><strong>Results: </strong>Although 66% of caregivers showed good home safety practices, 29% of caregivers reported depressive symptoms. Caregivers with extended caregiving duration (more than 5 years) demonstrated significantly better home safety practices as compared to those with shorter duration (AOR: 5.68, 95% CI: 1.76-18.33, p = 0.004). Further, depressed caregivers provided poor service as compared to non-depressed caregivers (AOR: 2.94, 95% CI: 1.19-7.24, p = 0.019).</p><p><strong>Conclusion: </strong>Short-term and long-term dementia training aligning with cultural values and traditions of Saudi Arabia are required to ensure the care of such persons living with dementia is achieved in an effective and respectful way. Moreover, trained caregivers can improve quality of life, delay institutionalization and reduce healthcare costs.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"19 ","pages":"604540"},"PeriodicalIF":2.6,"publicationDate":"2026-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13332311/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148392347","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 Long-Term Care Insurance Improve Health and Shift Healthcare Utilization? Evidence from China's Pilot Program.","authors":"Xinfang Li, Mingqiang Li, Zhihui Li","doi":"10.2147/RMHP.S605993","DOIUrl":"10.2147/RMHP.S605993","url":null,"abstract":"<p><strong>Background: </strong>China introduced long-term care insurance (LTCI) pilot programs in 2016 to address the growing care needs of an aging population and the increasing number of disabled older adults. While LTCI is expected to improve health and reduce the financial burden of care, its broader impacts on healthcare utilization remain unclear.</p><p><strong>Methods: </strong>Using four waves of the China Health and Retirement Longitudinal Study (CHARLS) from 2011 to 2018, this study examines the health and economic effects of LTCI using a difference-in-differences approach. The analysis focuses on middle-aged and older adults with functional disabilities in 15 pilot cities that implemented LTCI between 2016 and 2017, compared with individuals in non-pilot cities.</p><p><strong>Results: </strong>The results show that LTCI is associated with improvements in self-reported health and memory function. In addition, LTCI is associated with reductions in inpatient visits and associated medical expenditures and an increase in outpatient visits, suggesting a shift in healthcare utilization from inpatient to outpatient services.</p><p><strong>Conclusion: </strong>These findings from pilot cities and observational longitudinal survey data suggest that LTCI may contribute to improved health outcomes. The results provide new empirical evidence on the broader impacts of LTCI and offer policy implications for countries facing rapid population aging.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"19 ","pages":"605993"},"PeriodicalIF":2.6,"publicationDate":"2026-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13331017/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148392370","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":"Spatial Epidemiology of the Ischemic Heart Disease-Asthma Comorbidity: A Global Analysis of Burden Patterns, Risk Drivers, and a Composite Risk Index.","authors":"Sha Fan, Lu Wang, Shufen Zhang, Xiaojing Wu","doi":"10.2147/RMHP.S619944","DOIUrl":"10.2147/RMHP.S619944","url":null,"abstract":"<p><strong>Background: </strong>Although ischemic heart disease (IHD) and asthma are major contributors to the global disease burden, the geographical distribution patterns of their comorbidity and its macro-level drivers remain unclear. This study aims to analyze the global spatial distribution of IHD-asthma comorbidity and to identify the key risk factors driving this comorbid pattern.</p><p><strong>Methods: </strong>Based on a secondary analysis of the Global Burden of Disease Study 2021, this study categorized 204 countries and territories worldwide into three spatial patterns-namely \"concordant type\", \"IHD-dominant type\", and \"asthma-dominant type\"-using the quartile method of disability-adjusted life years (DALYs). A three-stage screening approach was employed to identify significant risk factors: random forest modeling combined with Shapley additive explanations was first used to rank and select candidate variables, followed by negative binomial regression analysis to confirm significant associations. Furthermore, population attributable fraction and a composite risk index were constructed to quantify cumulative exposure levels.</p><p><strong>Results: </strong>Approximately one-quarter of countries worldwide exhibit a \"concordant pattern\" of disease burden levels, primarily located in Asia, Africa, and Oceania. Thirteen significant risk factors were identified, with deficiency in omega-6 polyunsaturated fatty acids and iron deficiency being common risk factors for both diseases. Overall, 43.083% of IHD DALYs and 28.963% of asthma DALYs were attributable to the combined exposure to their respective risk factors.</p><p><strong>Conclusion: </strong>The global joint burden of IHD and asthma exhibits substantial spatial heterogeneity, with particularly severe challenges in socioeconomically resource-limited regions of Africa and Asia. Comprehensive strategies integrating nutritional interventions, environmental improvements, and metabolic risk control are crucial for mitigating the global burden of cardiopulmonary comorbidities.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"19 ","pages":"619944"},"PeriodicalIF":2.6,"publicationDate":"2026-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13310406/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148347316","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":"Health Equity Barriers to Accessing Vaccination and Screening Services in Low- and Middle-Income Countries: A Narrative Review.","authors":"Rano K Sinuraya, Maarten J Postma, Irma M Puspitasari, Auliya A Suwantika","doi":"10.2147/RMHP.S612390","DOIUrl":"10.2147/RMHP.S612390","url":null,"abstract":"<p><p>Vaccination and screening services are essential components of preventive care, yet access to these services remains unequal in many low- and middle-income countries (LMICs). This narrative review examines health equity barriers affecting access to vaccination and screening services in LMICs, with screening evidence drawn predominantly from cervical cancer/HPV-related programs and selected other preventive screening contexts, and identifies strategies to improve equity in preventive care. Relevant English-language literature was identified through PubMed and Scopus and synthesized thematically. The review examined cross-cutting equity barriers across vaccination and the screening contexts represented in this evidence base. Barriers operated across individual and household, community and sociocultural, health system, and policy and structural domains. Common barriers included poverty, transportation costs, low health literacy, stigma, weak primary care, workforce shortages, and inadequate financing. Vaccination-specific challenges included weak cold-chain systems, reliance on campaign-based delivery, vaccine hesitancy, and missed immunization schedules, whereas screening-specific challenges included repeated visits, weak referral and follow-up systems, stigma related to cancer and reproductive health screening, and delayed diagnosis. These barriers disproportionately affected rural populations, low-income households, women and girls, migrants, ethnic minorities, people with disabilities, and other marginalized groups, contributing to persistent inequities by income, gender, education, and rural-urban residence. Advancing equity in preventive care requires strengthening primary health care, reducing financial and geographic barriers, improving culturally responsive communication, using disaggregated data for equity-focused planning, and investing in workforce and service delivery improvements.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"19 ","pages":"612390"},"PeriodicalIF":2.6,"publicationDate":"2026-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13308728/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148347405","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":"Clinical Practice of the Proactive Health Concept in Chronic Disease Management: A Qualitative Study from the Perspective of Neurology Medical Staff.","authors":"Xiaoyun Xu, Yanlin Chen, Ying Zhang, Lie Lu","doi":"10.2147/RMHP.S607825","DOIUrl":"10.2147/RMHP.S607825","url":null,"abstract":"<p><strong>Background: </strong>This qualitative study explores the understanding and clinical practice of the proactive health concept among neurology medical staff in managing chronic neurological disorders.</p><p><strong>Methods: </strong>Semi-structured interviews were conducted with 15 healthcare professionals from a tertiary hospital in China, and data were analyzed using Colaizzi's seven-step phenomenological method.</p><p><strong>Results: </strong>Five core themes emerged: (1) education and motivation as core strategies for promoting proactive health; (2) multidimensional factors influencing patient compliance, including cognition, emotion, and family support; (3) the dual role of medical tools and technologies in facilitating and hindering self-management; (4) the nascent state and mixed impact of external support systems such as patient groups and community services; and (5) systemic barriers including time constraints and lack of institutional support. Findings indicate that while medical staff recognize the value of proactive health, its implementation is hindered by individual patient differences, limited clinical resources, and underdeveloped external systems.</p><p><strong>Conclusion: </strong>The study highlights the need for a multi-level support environment involving institutional, policy, societal, and technological dimensions to enable the effective integration of proactive health into chronic disease management.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"19 ","pages":"607825"},"PeriodicalIF":2.6,"publicationDate":"2026-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13309618/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148347360","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":"Impact of Public Health Insurance on Reducing Out-of-Pocket Payment for Psychiatric Care Among Cross-Border Migrants in Thailand: A Two-Part Model and Machine Learning Approach.","authors":"Rapeepong Suphanchaimat, Akarawit Uttamavetin, Supanut Chotichavalrattanakul, Chosita Pavasuthipaisit","doi":"10.2147/RMHP.S592209","DOIUrl":"10.2147/RMHP.S592209","url":null,"abstract":"<p><strong>Purpose: </strong>Thailand has long implemented public insurance schemes for cross-border migrants, though psychiatric care is not explicitly included in the schemes' benefit package. As evidence related to the association between public insurance and migrants' out-of-pocket (OOP) expenditure for psychiatric services remains limited, this study aims to assess if and to what extent the insurance is associated with OOP spending among migrants utilizing psychiatric-related care in Thailand.</p><p><strong>Patients and methods: </strong>A cross-sectional analysis of routine service data was applied. We analyzed nationwide service utilization data of cross-border migrants receiving psychiatric care in public hospitals between 2018 and 2022. A two-part model (TPM) with machine learning was employed. The first part used a decision tree classifier to estimate the probability of incurring OOP spending, and the second part applied a non-negative least squares ensemble to predict the magnitude of OOP spending.</p><p><strong>Results: </strong>A total of 4,559 migrant patients accounted for 13,744 visits (inpatient and outpatient care combined), of which 84.1% were uninsured. The mean OOP spending per visit was 449 Baht, ranging from zero to 109,075 Baht. Public insurance was associated with about 50% reduction in the likelihood of incurring any OOP payment. After integrating both parts of the model, the estimated mean OOP spending per visit was 471.3 Baht (95% confidence interval [CI] = 433.8-511.3) among the uninsured, compared with 7.4 Baht (95% CI = 6.7-8.1) among the insured-about 98% OOP spending avoidance.</p><p><strong>Conclusion: </strong>Public insurance for cross-border migrants in Thailand was associated with reduced OOP spending for psychiatric services at the point of care. Inclusion of psychiatric services in migrant health insurance benefit packages may be considered as an option to help reduce inconsistent interpretations of coverage. Further research examining the financial burden of psychiatric illnesses among migrant households would be valuable. Ongoing monitoring of migrant-related policy changes may help inform future policy decisions.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"19 ","pages":"592209"},"PeriodicalIF":2.6,"publicationDate":"2026-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13289764/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148320837","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":"Minimum Procedural Volume Thresholds for Surgical Privileging: A Mixed-Methods Validation and Risk Management Framework in a Multi-Specialty Healthcare Network.","authors":"Nantana Suppapitnarm, Suthorn Bavonratanavech, Wanicha Panyakhamlerd, Pongtorn Kietdumrongwong","doi":"10.2147/RMHP.S608778","DOIUrl":"10.2147/RMHP.S608778","url":null,"abstract":"<p><strong>Purpose: </strong>To establish evidence-based annual procedural volume thresholds and surgical pairing standards for Orthopedics and Obstetrics-Gynecology (OB-GYN), and to validate these benchmarks against clinical incident rates as a proactive risk management tool.</p><p><strong>Methods: </strong>This study utilized a sequential mixed-methods design. In Phase 1, a Delphi technique was employed with 36 senior experts from the Bangkok Dusit Medical Services (BDMS) network to reach a consensus on minimum annual volumes and co-surgeon requirements. In Phase 2, a retrospective analysis of clinical incidents (Levels 4-5 and Sentinel Events) from 2022 to 2024 was performed to validate these thresholds. Statistical analysis included Mann-Whitney U and Kruskal-Wallis tests to evaluate the association between sustained compliance with these standards and clinical incident rates.</p><p><strong>Results: </strong>Expert consensus established a recommended safety threshold of 10 cases per year for high-volume procedures (eg, cesarean delivery, anterior cruciate ligament [ACL] reconstruction), with specific thresholds of 6 cases for proximal humerus fracture and 5 cases for shoulder rotator cuff repair. Quantitative validation demonstrated that surgeons meeting these thresholds had significantly lower incident rates in cesarean delivery (p < 0.001), proximal humerus fractures (p = 0.027), and shoulder rotator cuff repair (p < 0.001). Furthermore, sustained multi-year compliance over three consecutive years was strongly correlated with lower incident rates (p < 0.001). For high-complexity, low-volume procedures, the strategy shifted from numerical frequency to system-based redundancy, requiring a mandatory co-surgeon (Median Score = 5.0 on a 5-point scale).</p><p><strong>Conclusion: </strong>Maintaining a minimum annual procedural volume serves as a core proxy for surgical competency, directly reinforcing the knowledge, skill, and attitude required for patient safety. These established thresholds and team-based safety models provide a data-driven framework for institutional clinical privileging, offering hospital administrators an objective policy tool for proactive risk management.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"19 ","pages":"608778"},"PeriodicalIF":2.6,"publicationDate":"2026-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13283398/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148304213","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":"Professional Compromise and Its Association with Burnout, Job Satisfaction, and Patient Satisfaction Among Physicians in a Chinese Tertiary Hospital.","authors":"Yulin Zeng, Ping Han","doi":"10.2147/RMHP.S601873","DOIUrl":"10.2147/RMHP.S601873","url":null,"abstract":"<p><strong>Background: </strong>Physician burnout poses a global challenge to healthcare systems. Professional compromise-pressure on physicians to deviate from clinical judgment or professional standards due to systemic constraints-may contribute to burnout, yet evidence from non-Western settings remains limited. This study examined the prevalence of professional compromise among physicians at a Chinese tertiary hospital and its associations with burnout, job satisfaction, turnover intention, and departmental patient satisfaction.</p><p><strong>Methods: </strong>A cross-sectional survey was conducted between January and March 2025 at a tertiary hospital in Zhejiang Province, China (n=120 physicians; 10 clinical departments; response rate 80.0%). Professional compromise was measured with a validated five-item instrument adapted from the Measure of Moral Distress for Healthcare Professionals; burnout was assessed using the Emotional Exhaustion subscale of the Maslach Burnout Inventory (licensed from Mind Garden, Inc). Pearson correlations, independent t-tests, and chi-square tests examined associations; effect sizes were quantified using Cohen's d and odds ratios.</p><p><strong>Results: </strong>The mean professional compromise score was 3.85 (SD 0.55) on a 1-5 scale, with 50.0% of physicians reporting frequent compromise (score ≥4). Obstetrics and Gynaecology and Emergency Medicine departments exhibited the highest compromise rates. Professional compromise correlated positively with burnout (r=0.587, p<0.001) and negatively with job satisfaction (r=-0.347, p<0.001). High-compromise physicians had substantially higher burnout (Cohen's d=0.97), lower job satisfaction (Cohen's d=0.57), and greater turnover intention (55.0% vs. 28.3%; OR=3.09, 95% CI 1.41-6.77). At the department level (n=10), professional compromise correlated negatively with patient satisfaction (r=-0.929, p<0.001).</p><p><strong>Conclusion: </strong>Professional compromise was prevalent and robustly associated with adverse clinician outcomes. These findings suggest that systemic contributors to professional compromise warrant attention in strategies to improve clinician well-being and healthcare quality. Longitudinal multi-site research is needed to confirm these associations and evaluate targeted interventions.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"19 ","pages":"601873"},"PeriodicalIF":2.6,"publicationDate":"2026-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13282957/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148297380","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 Role of Information Technology in Strengthening Vital Statistics in Public Health Institutions in Sana'a, Yemen.","authors":"Al-Safi Noman, Kassim Alshargabi, Sarah Noman","doi":"10.2147/RMHP.S609380","DOIUrl":"10.2147/RMHP.S609380","url":null,"abstract":"<p><strong>Background: </strong>Reliable vital statistics are essential for evidence-based health planning, policy formulation, and population health monitoring. In fragile and conflict-affected settings, however, weak digital infrastructure and fragmented health information often compromise data quality, timeliness, and accessibility. These limitations restrict the availability of reliable information for effective decision-making. Strengthening information technology (IT) capacity may therefore play a critical role in improving the performance and reliability of vital statistics in resource-constrained health settings.</p><p><strong>Methods: </strong>This study employed a quantitative cross-sectional design to examine the role of IT in enhancing vital statistics in public health institutions in Sana'a, Yemen. Data were collected from 119 administrative and technical staff across 32 public health institutions using a structured questionnaire measuring key IT dimensions (devices and equipment, software, human resources, and networks and communications) and vital statistics dimensions (registration and compilation, coverage and inclusiveness, data accuracy and quality, and publishing). Structural Equation Modeling (SEM) was applied to assess the relationship between IT capabilities and the performance of vital statistics. Due to the cross-sectional design, the results should be interpreted as associations rather than causal effects.</p><p><strong>Results: </strong>The findings revealed a strong and statistically significant positive relationship between IT and vital statistics performance (β = 0.83, p < 0.001), with IT explaining a substantial proportion of the variation in system performance <i>(R²</i> = 0.69). Descriptive results indicated moderate utilization of IT, alongside relatively high performance of vital statistics systems. This pattern suggests that even partial adoption of digital technologies contributes meaningfully to improving data availability, accuracy, and reporting efficiency in resource-constrained settings.</p><p><strong>Conclusion: </strong>This study provides empirical evidence that IT capabilities are strongly associated with improved performance of vital statistics in fragile and conflict-affected contexts. By demonstrating how digital capacity supports data reliability and informed decision-making under constrained conditions, the findings highlight the critical role of IT in strengthening data systems and addressing operational challenges. Targeted investments in digital infrastructure, workforce capacity, and system integration are essential for building resilient and data-driven health systems in similar settings.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"19 ","pages":"609380"},"PeriodicalIF":2.6,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13281882/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148297438","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 Factors and Development of a Risk Prediction Model for PICC-Related Thrombosis in Radiotherapy Inpatients: A Single-Center Retrospective Cohort Study.","authors":"Qin-Mei Lin, Qin-Lin Guo, Zhuang-Bin Lin, Ai-Ying Chen, Zhen Chen, Qiu-Yan Zhang, Li-Yuan Chen, Bi-Hua Lin","doi":"10.2147/RMHP.S608590","DOIUrl":"10.2147/RMHP.S608590","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to identify independent risk factors associated with peripherally inserted central catheter-related venous thrombosis (PICC-RVT) in patients undergoing radiotherapy and to develop a risk prediction model to support early identification and inform targeted preventive strategies.</p><p><strong>Methods: </strong>A single-center retrospective cohort study was conducted involving 335 patients with malignant tumors who underwent PICC placement in the Department of Radiotherapy Oncology between August 2023 and September 2024. Participants were randomly assigned to a modeling group (n = 250) and a validation group (n = 85) in a 3:1 ratio. Univariate analyses were conducted to identify potential risk factors, followed by multivariate logistic regression to determine independent predictors. A risk prediction model was subsequently constructed, and its performance was assessed using receiver operating characteristic (ROC) curve analysis.</p><p><strong>Results: </strong>Of the 335 patients who underwent ultrasound examination, 70 were found to have thrombosis, yielding a PICC-related thrombosis incidence of 20.89% (70/335). Of these, 5 cases (7.14%) were symptomatic and 65 (92.86%) were asymptomatic. Univariate analysis indicated significant associations between thrombosis and both disease diagnosis (<i>p</i> = 0.007) and total cumulative radiation dose (<i>p</i> = 0.049). Multivariate logistic regression identified total cumulative radiation dose (odds ratio = 1.020, 95% confidence interval: 0.962-0.999) and a history of thrombosis (odds ratio = 6.838, 95% confidence interval: 1.084-43.157) as independent risk factors. The area under the ROC curve was 0.589 in the modeling group and 0.591 in the validation group. Sensitivity values were 74.5% and 83.3%, respectively; however, specificity remained limited (43.9% in the modeling group and 39.4% in the validation group).</p><p><strong>Conclusion: </strong>The predictive model identified total cumulative radiation dose and a prior history of thrombosis as independent risk factors for PICC-RVT in patients receiving radiotherapy. However, the model's specificity was low, restricting its utility to preliminary screening. Future studies with larger sample sizes and multicenter validation are needed to optimize the model and improve its predictive performance.</p>","PeriodicalId":56009,"journal":{"name":"Risk Management and Healthcare Policy","volume":"19 ","pages":"608590"},"PeriodicalIF":2.6,"publicationDate":"2026-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13265402/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148267165","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}