Frontiers in health services最新文献

{"title":"Influence of working conditions on German paramedics' intention to leave the profession: a cross-sectional study.","authors":"Thomas Hofmann, Michael Stanley, Luis Möckel","doi":"10.3389/frhs.2025.1548525","DOIUrl":"https://doi.org/10.3389/frhs.2025.1548525","url":null,"abstract":"<p><strong>Introduction: </strong>It is well known that Germany's ambulance service (AS) suffers from a shortage of qualified personnel, which may increase in the following years. For this reason, this study aimed to determine the percentage of AS staff considering leaving their profession and to analyse the possible causes.</p><p><strong>Methods: </strong>A self-developed questionnaire and the Employee Experience Questionnaire (EXQ) were used for this cross-sectional study.</p><p><strong>Results: </strong>A total of 814 AS staff with a mean age of 35.71 [standard deviation (SD) 9.78] years were included in this study. Immediately leaving the AS was the intention of 17.27% of participants, with 2.86% having already resigned, 14.29% taking actions such as applying for a job, and another 14.04% specifically planning to leave the AS in the foreseeable future. Those who plan to leave the AS immediately [3.82 (SD 0.79)] showed significantly lower EXQ scores than the group who plan to stay in the EMS until retirement [4.92 (SD 0.87); p_Tukey ≤0.001]. At the same time, it is noticeable that EMS staff often suffer from unfavourable working conditions, such as not being granted breaks, work-related calls during free time, and over time, and significant correlations with the planned length of stay in the paramedic service and exit thoughts were identified here.</p><p><strong>Conclusion: </strong>Unfavourable working conditions further aggravate the already existing shortage of qualified personnel in the ambulance service, so measures by various decision-makers are imperative.</p>","PeriodicalId":73088,"journal":{"name":"Frontiers in health services","volume":"5 ","pages":"1548525"},"PeriodicalIF":1.6,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11825466/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143434337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perspectives of health workers on the facilitators and barriers to antiretroviral therapy adherence following intensive adherence counseling in Northern Uganda.","authors":"Humphrey Beja, Daisy Nakayiwa, Innocent Ocitti Owachgiu, Micheal Tonny Edek, Veronic Kobusinge, Oscar Akaki, Samson Udho","doi":"10.3389/frhs.2025.1387823","DOIUrl":"10.3389/frhs.2025.1387823","url":null,"abstract":"<p><strong>Background: </strong>In some contexts, people living with HIV (PLWH) who are virally non-suppressed and participating in an intensive adherence counseling (IAC) program have demonstrated non-adherence to antiretroviral therapy (ART) even after IAC. There is limited literature on the facilitators and barriers to ART adherence following IAC.</p><p><strong>Objective: </strong>This study aimed to explore the perspectives of healthcare workers (HCWs) on the facilitators and barriers to ART adherence following IAC among PLWH in Northern Uganda.</p><p><strong>Methods: </strong>This was a descriptive qualitative study conducted among HCWs at the ART clinics of the two highest-volume public health facilities in Lira District. We purposively sampled 15 study participants and conducted face-to-face in-depth interviews using an interview guide formulated based on the components of the Capability, Opportunity, and Motivation framework for Behavior change (COM-B framework). Thematic analysis was used based on the COM-B framework. In this study, the desired behavior was ART adherence following IAC. Factors that were perceived to positively affect any component of the COM-B framework were classified as facilitators and those that were perceived to negatively affect were classified as barriers.</p><p><strong>Results: </strong>The majority of the participants were females (53%), diploma holders (40%), and nurses (40%). The perceived facilitators and barriers to ART adherence following IAC emerged as six key themes under the subdivisions of the three domains of the COM-B framework: cognitive and emotional processes, physical and practical skills, accessibility and material resources, social relationships and cultural dynamics, cognitive beliefs and aspirations, and finally, <i>emotional</i> and subconscious drivers. These themes were identified as either facilitators or barriers to ART adherence following IAC depending on the lenses of interpretation.</p><p><strong>Conclusions: </strong>This study offers a multidimensional insight into the facilitators and barriers to ART adherence following IAC and how the behavior influencing ART adherence can be optimized. The results suggest that optimizing cognitive and emotional processes, physical and practical skills, accessibility and material resources, social relationships and cultural dynamics, cognitive beliefs and aspirations, and emotional and subconscious drivers during IAC and any ART adherence-related intervention could yield the best level of ART adherence among the PLWH who are virally non-suppressed and on ART.</p>","PeriodicalId":73088,"journal":{"name":"Frontiers in health services","volume":"5 ","pages":"1387823"},"PeriodicalIF":1.6,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11810930/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143400752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing access to primary care is critical to the future of an equitable health service: using process visualisation to understand the impact of national policy in the UK.","authors":"Ian Litchfield, Nicola Kay Gale, Sheila Greenfield, David Shukla, Micheal Burrows","doi":"10.3389/frhs.2024.1499847","DOIUrl":"10.3389/frhs.2024.1499847","url":null,"abstract":"<p><p>Access to UK general practice is complicated by the need to provide equitable and universal care within a system adapting to workforce challenges, digital innovation, and unprecedented demand. Despite the importance of accessing primary care in meeting the overall aim of delivering equitable care, this is the first time the direct and indirect influence of policies intended to facilitate access have been systematically explored. Further consideration by policymakers is needed to accommodate the difference between what patients need and what patients want when accessing primary care, and the differences in their ability to utilise digital options. The designation of care was hindered by long-standing issues of reliable data and variations in the interpretation of local and national protocols and guidelines.</p>","PeriodicalId":73088,"journal":{"name":"Frontiers in health services","volume":"4 ","pages":"1499847"},"PeriodicalIF":1.6,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11807964/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143392609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum: Organizational readiness for change towards implementing a sepsis survivor hospital to home transition-in-care protocol.","authors":"Elaine Sang, Ryan Quinn, Michael A Stawnychy, Jiyoun Song, Karen B Hirschman, Sang Bin You, Katherine S Pitcher, Nancy A Hodgson, Patrik Garren, Melissa O'Connor, Sungho Oh, Kathryn H Bowles","doi":"10.3389/frhs.2025.1552666","DOIUrl":"https://doi.org/10.3389/frhs.2025.1552666","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.3389/frhs.2024.1436375.].</p>","PeriodicalId":73088,"journal":{"name":"Frontiers in health services","volume":"5 ","pages":"1552666"},"PeriodicalIF":1.6,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11803503/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143384332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Measuring how healthcare organizations respond after patients experience harm: perspectives and next steps.","authors":"Lauge Sokol-Hessner, John Adams, Carole Hemmelgarn, Beth Miller, Diane O'Connor, Melissa Parkerton, Leilani Schweitzer, J Matthew Austin","doi":"10.3389/frhs.2024.1488944","DOIUrl":"10.3389/frhs.2024.1488944","url":null,"abstract":"<p><p>Patients can experience serious harm from healthcare, the impacts can be prolonged, and events may also affect families and clinicians. Communication and Resolution Programs (CRPs) are designed to reduce these negative impacts, rebuild trust, and improve patient safety, but are not consistently implemented. To inform implementation efforts, enable accountability, and promote innovation, it is critical to develop standardized performance measures assessing CRPs' structure, process, and outcomes. To advance CRP measurement, an interdisciplinary workgroup from the Pathway to Accountability, Compassion, and Transparency (PACT) Leadership and Innovation Network-a group of leading healthcare organizations with CRPs-explores meaningful approaches to measurement and proposes a set of next steps. Interested parties in CRP measurement prioritize developing person-centered outcome and experience measures; assessing equity; addressing clinician and organization concerns about how CRP measurement may affect reputational and legal risk; reducing the burden of measurement; and improving mechanisms for sharing data across organizations to promote transparency, accountability, and broader patient safety improvements. Recommended next steps include: build a national coalition of interested parties to guide the work; overcome barriers to measurement and improve feasibility, especially through the engagement of patient safety and risk management software vendors; explore measure development processes that focus on patient, family, and clinician-centered outcome and experience measures; define nationally recognized standardized CRP measures; consider the role for regulatory and financial incentives to promote their use; and facilitate data sharing and comparative analysis. Ongoing engagement and strategy will be essential to move CRP measurement forward.</p>","PeriodicalId":73088,"journal":{"name":"Frontiers in health services","volume":"4 ","pages":"1488944"},"PeriodicalIF":1.6,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11790648/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143191454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"It's a good idea, but…\": a qualitative evaluation of the GoldiCare intervention in Norwegian home care services.","authors":"Heike Fischer, Fredrik Klæboe Lohne, Marius Steiro Fimland, Skender Elez Redzovic","doi":"10.3389/frhs.2024.1511772","DOIUrl":"10.3389/frhs.2024.1511772","url":null,"abstract":"<p><strong>Background: </strong>Addressing high levels of physical strain among Norwegian home care workers is crucial if home care services are to continue to provide cost-effective and high-quality health care for people in their homes. Excessive physical demands may contribute to poor long-term musculoskeletal health and high sick leave rates among home care workers. Based on the Goldilocks Work Principle of redistributing an uneven distribution of physical demands to promote a working environment with a \"just right\" physical demands conducive to promoting long-term health, the GoldiCare intervention in home care services was conducted. The objective of this qualitative process evaluation study was to gain insights into how the implementation outcomes of acceptability, appropriateness, feasibility, adoption and fidelity, respectively, impacted the implementation of the GoldiCare intervention.</p><p><strong>Methods: </strong>We conducted ten individual interviews with operations managers and five focus group interviews with home care workers from the intervention units. Interviews were transcribed verbatim and a three step-content analysis was employed to analyze interview material.</p><p><strong>Results: </strong>Our analysis identified that although the intervention was considered broadly acceptable, there were several challenges corresponding to the dimensions of appropriateness, feasibility, adoption and fidelity. Major barriers were identified in particular with regard to appropriateness, that is underlying ways of measuring physical demands; and feasibility, that is barriers to implementing the tool. Further synthesis of these findings resulted in four core issues that need to be addressed if the GoldiCare intervention is to be successfully implemented in comparable Norwegian home care settings: proxy issues; complexity and unpredictability; organization-level issues; and operational autonomy.</p><p><strong>Conclusion: </strong>The findings provide valuable insights for future attempts to implement GoldiCare interventions in home care settings, highlighting the need to further integrate GoldiCare and other comparable types of intervention into the political, economic, sociocultural, professional, and technological context of home care services. Performed in the right way, such integration will also allow for more participatory input from those enacting such interventions.</p><p><strong>Trial registration: </strong>This clinical trial was registered on 08/05/2022 under NCT05 487027.</p>","PeriodicalId":73088,"journal":{"name":"Frontiers in health services","volume":"4 ","pages":"1511772"},"PeriodicalIF":1.6,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11789199/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143124091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Economic evaluation of a strategy to shorten the time to surgery with neuraxial anaesthesia compared with usual clinical practice in patients on chronic antiplatelet therapy with a proximal femur fracture.","authors":"Claudia Erika Delgado-Espinoza, Rosa Maria Antonijoan, Ignasi Gich, Rafael Anaya, Mireia Rodriguez, Angélica Millan, Jordi Llorca, Gemma Usua, Ana Ruiz, Angela Merchán-Galvis, Maria Jose Martinez-Zapata","doi":"10.3389/frhs.2024.1423975","DOIUrl":"10.3389/frhs.2024.1423975","url":null,"abstract":"<p><strong>Introduction: </strong>Before implementing a new health care strategy, it is important to assess effectiveness but also to perform an economic evaluation. The goal of the present study was to perform a comparative economic evaluation of a new strategy aimed at using proposed implementation of the Plateletworks guidance (measurement of platelet function) with usual practice (delayed time to surgery) in patients on chronic antiplatelet treatment and scheduled for surgery with neuraxial anaesthesia due to proximal femur fracture.</p><p><strong>Methods: </strong>This is an economic evaluation carried out alongside a randomised controlled clinical trial at four centres in Spain. Patients were randomised to undergo either early platelet function-guided surgery (experimental group) or delayed surgery (control group). As AFFEcT trial results demonstrated significative difference between groups in the primary efficacy endpoint, the median time to surgery, a cost-effectiveness analysis was performed. Direct costs associated with hospitalisation until one-month post-discharge were considered and measured from a hospital perspective. All costs were reported in euros. Analyses were performed on a per protocol basis. Effectiveness outcome measures were the incremental cost and incremental cost per reduction in days to surgery. A deterministic sensitivity analysis was implemented to quantify uncertainty.</p><p><strong>Results: </strong>A total of 156 patients were randomized to the two groups (<i>n</i> = 78 per group). A total of 143 patients were included in the per protocol population (75 and 68 patients in the experimental and control groups, respectively). The median time to surgery was 2.30 days (IQR: 1.53-3.73) in the experimental group and 4.87 days (4.36-5.60) in the control group (a reduction of 2.40 days). Total costs during the 1-month study perioperative period were higher in the delayed surgery group (€18,495.19) than for the early surgery group (€16,497.59). The incremental cost was negative (€1,997.60), a statistically significant difference (<i>P</i> < 0.05). As measured by the reduction in time (days) to surgery, the incremental cost-effectiveness ratio (ICER) for early surgery was negative (777.28€/day). Sensitivity analysis demonstrated consistent cost saving.</p><p><strong>Conclusion: </strong>For patients on chronic antiplatelet treatment scheduled to undergo surgery for proximal femur fracture, an individualised strategy guided by a platelet function testing is a cost-saving and cost-effective strategy.</p>","PeriodicalId":73088,"journal":{"name":"Frontiers in health services","volume":"4 ","pages":"1423975"},"PeriodicalIF":1.6,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11788385/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143124093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"On the epistemology of resilience in public health: a novel perspective in a changing world.","authors":"Alessandro Jatobá, Paula Castro-Nunes, Paulo Victor Rodrigues de Carvalho","doi":"10.3389/frhs.2024.1453006","DOIUrl":"10.3389/frhs.2024.1453006","url":null,"abstract":"<p><p>This review proposes the foundations for an epistemology of resilience in public health, addressing the need for a theoretical framework to guide research and policy. Resilience, often ambiguously defined, is reexamined here as a critical attribute of public health systems, enabling them to adapt, absorb, and respond to routine and extraordinary demands without compromising universal and equitable service delivery. By integrating logical, sociological, historical, and philosophical perspectives, the paper delineates resilience as a structured and measurable concept, distinguishing it from common ambiguities in academic and policy discourse. It further introduces a set of foundational axioms to clarify the boundaries of resilience and support its operationalization within public health. These axioms emphasize the interplay between structural and functional dynamics, responses to internal and external stressors, and the importance of systems-level design over reliance on individual adaptations. This epistemological approach aims to bridge the gap between theory and practice, providing a robust basis for developing evidence-based policies that strengthen public health systems' ability to meet evolving challenges while promoting equity and universality.</p>","PeriodicalId":73088,"journal":{"name":"Frontiers in health services","volume":"4 ","pages":"1453006"},"PeriodicalIF":1.6,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11782274/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143082527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors affecting decision making among nurse managers working in government hospitals.","authors":"Wubete Abeje, Belachew Tegegne, Zenebe Tefera, Yosef Zenebe, Wondwossen Yimam, Birhanu Desu, Yismaw Andargie, Muluken Amare, Molla Kassa, Mulugeta W/Selassie","doi":"10.3389/frhs.2024.1475402","DOIUrl":"https://doi.org/10.3389/frhs.2024.1475402","url":null,"abstract":"<p><strong>Background: </strong>Effective nursing management and leadership are essential for the provision of desired patient care that will contribute to the improvement of any country's health indicators. However, nurses' views and experiences on the multitude of personal and organizational factors which may impact their decision-making abilities are often neglected in the literature. The study aimed to assess magnitude of poor decision making and its associated factors among nurse managers in South Wollo Zone Governmental Hospitals, Amhara Regional State, Ethiopia, 2023.</p><p><strong>Methods: </strong>Non experimental cross-sectional study was conducted among 168 nurse managers in South Wollo Zone Public Hospitals from April 01 2023 to May 15/2023. Participants were selected by using a simple random sampling technique. The data were collected by using structured questionnaire from the study participants. Data were entered using EPI data version 4.6 and exported to SPSS version 26 for analysis. The bi-variable logistic regression analysis model was used to identify the potential predictor variable, with <i>p</i>-value <0.25 was fitted into the multivariable logistic regression analysis model; <i>p</i>-value less than 0.05 and an adjusted odds ratio (AOR) with a 95% confidence interval (CI) was used to declare, factors associated with the outcome variable. The model fitness was checked by using the Hosmer and Lemeshow test. Data were presented with frequency tables, graphs, and pie charts.</p><p><strong>Results: </strong>The study found that the overall magnitude of poor decision-making among nurse managers was 35.7%. Being self-confident [AOR = 0.01, 95% CI: (00.002, 0.05)], receiving feedback [AOR = 0.24, 95% CI: 0.08, 0.76], and getting managerial support [AOR = 0.22, 95% CI: (0.06, 0.81)] were negatively associated with poor decision-making among nurse managers.</p><p><strong>Conclusion: </strong>Self-confidence, receiving feedback, and getting managerial support were variables significantly associated with poor decision-making. Authors strongly emphasize providing managerial support for nurse managers, increasing their habit of receiving feedback from colleagues, and encouraging them to build their self-confidence.</p>","PeriodicalId":73088,"journal":{"name":"Frontiers in health services","volume":"4 ","pages":"1475402"},"PeriodicalIF":1.6,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11774871/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143070055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Engaging older adults in diagnostic safety: implementing a diagnostic communication note sheet in a primary care setting.","authors":"Alberta Tran, Leah Blackall, Mary A Hill, William Gallagher","doi":"10.3389/frhs.2024.1474195","DOIUrl":"10.3389/frhs.2024.1474195","url":null,"abstract":"<p><strong>Introduction: </strong>Adults over the age of 65 are at a higher risk for diagnostic errors due to a myriad of reasons. In primary care settings, a large contributor of diagnostic errors are breakdowns in information gathering and synthesis throughout the patient-provider encounter. Diagnostic communication interventions, such as the Agency for Healthcare Research and Quality's \"Be the Expert on You\" note sheet, may require adaptations to address older adults' unique needs.</p><p><strong>Methods: </strong>We recruited and partnered with older adult patients (<i>n</i> = 6) in focus group sessions to understand their perspectives on diagnostic communication and the existing AHRQ note sheet. A two-page communication and clinic workflow tool was developed and implemented over a 6-month period using three Plan-Do-Check-Act cycles. Physicians, nurses, staff, and patients were surveyed.</p><p><strong>Results: </strong>Most older adult patients (<i>n</i> = 31) found the tailored diagnostic communication note sheet to be easy-to-use, helpful for provider communication, and would recommend its use to other patients. Physicians and staff members were satisfied with the note sheet and described few challenges in using it in practice.</p><p><strong>Discussion: </strong>Our findings contribute to the growing body of evidence around diagnostic safety interventions and patient engagement by demonstrating the feasibility and benefits of actively involving older adult patients in quality initiatives.</p>","PeriodicalId":73088,"journal":{"name":"Frontiers in health services","volume":"4 ","pages":"1474195"},"PeriodicalIF":1.6,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11769972/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143054193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}