Frontiers in health services最新文献

{"title":"Tackling low-value care in Singapore: progress, pitfalls, and prospects.","authors":"Marie Ann Mae En Wong, Michael Anderson, Martin Scherer, Jose M Valderas","doi":"10.3389/frhs.2026.1971597","DOIUrl":"10.3389/frhs.2026.1971597","url":null,"abstract":"<p><p>Low-value care is an important challenge for healthcare systems globally, contributing to unnecessary healthcare use and inefficient resource allocation. In Singapore, reducing low-value care is increasingly relevant given an ageing population, resource constraints and rising healthcare expenditure. However, local evidence on its prevalence, manifestations and underlying drivers remains limited. Available studies have identified potentially low-value practices in selected areas, while mechanisms established internationally, including patient expectations, clinician behaviours, financial incentives and organisational factors, may also be relevant locally but remain insufficiently characterised. Singapore has introduced initiatives to improve value and appropriateness of care, although publicly documented efforts have largely centred on public-sector and hospital-based settings, with less evidence from primary care and the private sector. Healthier SG may provide opportunities to support appropriate care through strengthened longitudinal primary care, although its impact on low-value care requires evaluation. International approaches, including evidence-based recommendations, measurement and feedback, payment mechanisms, and patient engagement provide potential lessons for local adaptation. Addressing low-value care in Singapore will require locally grounded research and coordinated, multi-component strategies across public and private sectors, accompanied by evaluation of appropriate care, outcomes, access and equity.</p>","PeriodicalId":73088,"journal":{"name":"Frontiers in health services","volume":"6 ","pages":"1971597"},"PeriodicalIF":2.6,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13661537/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149186567","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":"Shared decision-making for patients with psychotic disorders: validating the measure \"collaboRATE for Next of Kin acting to support patient autonomy\".","authors":"Roar Fosse, Irene Norheim, Jan Ivar Røssberg, Maria Romøren, Kristin Sverdvik Heiervang, Lars Hestmark, Reidar Pedersen","doi":"10.3389/frhs.2026.1887589","DOIUrl":"https://doi.org/10.3389/frhs.2026.1887589","url":null,"abstract":"<p><strong>Introduction: </strong>Family involvement and shared decision-making (SDM) are key elements in current mental health treatment. While it is important to measure the level of SDM from the perspective of relatives, suitable validated measures are lacking. Moreover, supported decision-making has gradually been emphasized more than substituted decision-making. In a large-scale implementation study of family involvement in the treatment of psychosis, we explored SDM for patients' closest relatives. We present the first validation of a three-item instrument to evaluate SDM for relatives acting to support patient autonomy, building on existing collaboRATE measures.</p><p><strong>Methods: </strong>For the new collaboRATE measure for relatives, we assessed scale reliability and concurrent and discriminant validity using available data from our implementation study. The study included relatives of patients treated for psychosis at community mental health centers, with data acquired and analyzed at baseline (<i>n</i> = 198 relatives) and 6-month follow-up (<i>n</i> = 173).</p><p><strong>Results: </strong>The new collaboRATE measure for relatives had excellent scale reliability, with Cronbach's alpha values ranging from 0.91 to 0.95. Scores on the collaboRATE for relatives were correlated with the scores on matching items from the Carer Well-Being and Support questionnaire, with Pearson <i>r</i> values varying from <i>r</i> = 0.49 to <i>r</i> = 0.66, supporting concurrent validity. Exploratory analysis provided further tentative support for concurrent validity, indicating significantly lower collaboRATE scores for relatives of patients in compulsory care compared to voluntary care. We observed small negative correlations between the collaboRATE scores and the relatives' responses to subscales of the Experience of Caregiving Inventory, which only partly supported discriminant validity.</p><p><strong>Conclusion: </strong>These validation data provide initial support for the new collaboRATE measure to assess SDM from the perspective of relatives supporting patient autonomy, although further validations are needed.</p>","PeriodicalId":73088,"journal":{"name":"Frontiers in health services","volume":"6 ","pages":"1887589"},"PeriodicalIF":2.6,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13662159/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149198291","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":"Operationalizing Iterative RE-AIM in two pragmatic nursing home trials to support an adaptation learning cycle.","authors":"Annie W Yang, Sophia Geisser, Amy Recker, Valerie Clark, Christine W Hartmann, A Lynn Snow","doi":"10.3389/frhs.2026.1847212","DOIUrl":"10.3389/frhs.2026.1847212","url":null,"abstract":"<p><strong>Introduction: </strong>Complex, heterogeneous settings such as nursing homes require ongoing adaptation of interventions and implementation strategies. Iterative RE-AIM offers a structured approach to guide adaptations, but how the approach is operationalized may need to vary across implementation contexts. We describe how two pragmatic nursing home trials operationalized Iterative RE-AIM with FRAME-IS to enable a systematic adaptation learning cycle.</p><p><strong>Methods: </strong>We conducted a narrative analysis of two ongoing multi-site trials: TEAM EFFORT (focused on falls reduction in State Veterans Homes) and 40 WINKS (focused on sleep improvement in nursing home residents with dementia). Both used RE-AIM for evaluation and FRAME-IS to document adaptations. Each operationalized the Iterative RE-AIM steps based on study scope, resources, team structure, and implementation timing, with a primary focus on refining a coach-supported implementation strategy.</p><p><strong>Results: </strong>TEAM EFFORT embedded adaptation-related data collection, deliberation, and decision-making within weekly team meetings, supported by an ongoing input tool; 40 WINKS used individual-level surveys followed by structured, once-per-wave team gatherings to decide on adaptations. These two operationalizations illustrate how the timing, methods, and cadence of an adaptation learning cycle based on Iterative RE-AIM can vary in response to implementation context.</p><p><strong>Discussion: </strong>Iterative RE-AIM can be operationalized differently across implementation contexts while remaining faithful to its underlying intent. Paired with FRAME-IS, Iterative RE-AIM can enable an adaptation learning cycle that integrates systematic documentation of adaptations with structured team deliberation. Rather than prescribing a single Iterative RE-AIM implementation protocol, these findings suggest that operationalization can respond to the context in which implementation occurs.</p>","PeriodicalId":73088,"journal":{"name":"Frontiers in health services","volume":"6 ","pages":"1847212"},"PeriodicalIF":2.6,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13661575/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149186538","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":"Antibiotic prescribing appropriateness among critically ill patients at a single tertiary care center in the United Arab Emirates: a retrospective cohort study.","authors":"Inas Kassis, Mosab Al Balas, Sheilla Hilal Hamed Rashid, Shabaz Mohiuddin Gulam, Jisha Myalil Lucca, Kimberly Caye McKeirnan, Vineetha Menon","doi":"10.3389/frhs.2026.1900610","DOIUrl":"https://doi.org/10.3389/frhs.2026.1900610","url":null,"abstract":"<p><strong>Objective: </strong>Despite expanding antimicrobial stewardship initiatives, evidence evaluating the appropriateness of antibiotic prescribing and its clinical implications in intensive care settings in the United Arab Emirates remains limited. This study aimed to assess the appropriateness of antibiotic prescribing among intensive care unit patients, identify factors associated with appropriate antibiotic therapy, and examine its association with clinical outcomes.</p><p><strong>Method: </strong>A retrospective cohort study was conducted in the intensive care unit of a tertiary care hospital in the Emirate of Abu Dhabi. Adult patients aged 18 years or older who were admitted between January 2023 and December 2024, had a length of stay exceeding 24 h but less than 30 days, received at least one systemic antibiotic, and had complete medical records were included. Data were extracted from electronic medical records and a regional health information exchange platform. Antibiotic appropriateness was evaluated against institutional or Infectious Diseases Society of America guidelines.</p><p><strong>Results: </strong>Overall, 36% of patients received inappropriate antibiotic therapy. The most common reason for inappropriateness was the absence of a clear indication, particularly for postoperative prophylaxis (44.4%). At the individual agent level, cefepime (48.2%), metronidazole (36.2%), and cefazolin (33.9%) exhibited the highest rates of inappropriate use. Multivariable logistic regression identified positive microbiological culture results (AOR = 3.34, <i>p</i> < 0.001) and sepsis (AOR = 2.12, <i>p</i> = 0.002) as factors independently associated with higher odds of appropriate antibiotic use. Conversely, the presence of a central venous catheter (AOR = 0.30, <i>p</i> = 0.003) was associated with lower odds of appropriate antibiotic use. Appropriate antibiotic therapy was associated with higher odds of organ dysfunction (AOR = 1.69, <i>p</i> = 0.032), nosocomial infection (AOR = 2.28, <i>p</i> = 0.005), and persistent infection despite therapy (AOR = 2.13, <i>p</i> = 0.005).</p><p><strong>Conclusion: </strong>Approximately one-third of patients received inappropriate antibiotic therapy, representing a substantial antimicrobial stewardship concern despite the observed strengths in culture-guided therapy and infection-focused management.</p>","PeriodicalId":73088,"journal":{"name":"Frontiers in health services","volume":"6 ","pages":"1900610"},"PeriodicalIF":2.6,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13662006/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149198340","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":"Integrating trauma-informed principles into collaborative care for depression in primary care.","authors":"Veronica Vitriol","doi":"10.3389/frhs.2026.1961806","DOIUrl":"10.3389/frhs.2026.1961806","url":null,"abstract":"<p><p>Depression remains one of the leading causes of disability worldwide despite the availability of effective pharmacological and psychological treatments. Collaborative care has consistently improved depression outcomes through coordinated, multidisciplinary, and measurement-based approaches, particularly in primary care. However, substantial heterogeneity in treatment response persists, especially among adults with histories of childhood maltreatment, who frequently present with earlier illness onset, greater symptom severity, increased psychiatric comorbidity, poorer treatment response, and a more chronic clinical course. Although collaborative care is effective, assessment of childhood maltreatment and trauma-informed developmental formulation are not consistently integrated into routine depression management within these models. In this Perspective, we propose Trauma-Informed Collaborative Care (TICC) as a conceptual framework for integrating trauma-informed and developmental principles into collaborative care for depression. Rather than replacing existing evidence-based interventions, TICC seeks to strengthen collaborative care by incorporating trauma-informed assessment, developmental case formulation, trusting therapeutic relationships, interdisciplinary supervision, recognition of patients' strengths and resilience, and organizational practices that promote safety, trustworthiness, collaboration, and empowerment. We review complementary bodies of evidence that provide the rationale for this approach, summarize findings from a recent cluster randomized controlled trial conducted in Chile, and discuss key implementation challenges and future research priorities. Taken together, these distinct bodies of evidence provide a rationale for integrating trauma-informed principles into collaborative care, particularly for patients with histories of childhood maltreatment and greater clinical complexity, while the incremental clinical benefit of this integration within the proposed TICC framework remains to be established.</p>","PeriodicalId":73088,"journal":{"name":"Frontiers in health services","volume":"6 ","pages":"1961806"},"PeriodicalIF":2.6,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13662067/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149186582","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":"Virtual reality-assisted psychological treatment of aggression for violent offenders: a pilot descriptive case series in maximum-security forensic psychiatry.","authors":"Fernando Renee González Moraga, Sean Perrin, Pia Enebrink, Kristina Sygel, Wim Veling, Märta Wallinius","doi":"10.3389/frhs.2026.1920018","DOIUrl":"https://doi.org/10.3389/frhs.2026.1920018","url":null,"abstract":"<p><strong>Background: </strong>Aggressive behaviour remains a major clinical challenge in forensic psychiatric care, and effective interventions targeting aggression are limited. Virtual Reality Aggression Prevention Treatment (VRAPT) is a manualized cognitive behavioural intervention that uses immersive virtual reality to provide individualized exposure to emotionally provocative interpersonal situations. Following a previous randomized controlled trial in Dutch forensic psychiatric care, the VRAPT protocol was revised to strengthen its theoretical foundation and therapeutic content. This pilot descriptive case series provides the first clinical description of the revised VRAPT protocol in patients receiving treatment in a Swedish maximum-security forensic psychiatric setting.</p><p><strong>Methods: </strong>A pilot descriptive case series was conducted in a maximum-security forensic psychiatric clinic. Fourteen patients initially consented to participate, of whom seven completed the intervention and follow-up assessments. The revised VRAPT protocol emphasized therapist-guided, individualized virtual reality scenarios targeting emotion regulation during emotionally provocative interpersonal situations. Clinical, psychological, behavioural, and process measures were collected to characterize the study population and describe individual trajectories during treatment and follow-up.</p><p><strong>Results: </strong>Participants who completed treatment generally reported moderate to high levels of perceived presence, suggesting that the virtual environments were experienced as immersive and sufficiently realistic. Individual trajectories varied across participants. Several participants showed favourable changes in measures of emotion regulation, self-reported anger, and aggression, whereas others showed stable or fluctuating trajectories over time. Staff-rated aggressive behaviour also varied considerably across participants. Exploratory group-level analyses did not indicate statistically significant changes. A 50% dropout rate highlighted the challenges associated with treatment engagement and retention in a maximum-security forensic psychiatric setting. The observations were consistent with the theoretical rationale underlying VRAPT, although the uncontrolled design precludes conclusions regarding treatment effectiveness.</p><p><strong>Conclusions: </strong>This pilot descriptive case series provides the first detailed clinical description of the revised VRAPT protocol in Swedish maximum-security forensic psychiatry. The findings provide descriptive clinical observations that may inform the design of future controlled studies, including randomized controlled trials and high-quality single-case experimental designs.</p>","PeriodicalId":73088,"journal":{"name":"Frontiers in health services","volume":"6 ","pages":"1920018"},"PeriodicalIF":2.6,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13658505/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149186575","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":"Community health worker denominations: a global review through the case of French Guiana.","authors":"Cássio de Figueiredo, Marc-Alexandre Tareau, Claire Boceno, Maylis Douine, Cyril Rousseau, Mathieu Nacher","doi":"10.3389/frhs.2026.1898370","DOIUrl":"https://doi.org/10.3389/frhs.2026.1898370","url":null,"abstract":"<p><p>Across more than 60 countries, individuals who bridge the gap between communities and formal health systems are designated by a wide array of terms-community health workers, <i>promotores de salud</i>, <i>agentes comunitários de saúde</i>, health mediators, and many others. This proliferation of denominations is often treated as a reflection of contextual diversity. This review argues that it also reveals a deeper structural reality: the incomplete institutionalisation of a workforce that is nonetheless essential to health systems worldwide. Drawing on a comparative analysis of over 60 denominations across regions, and grounded in the case of French Guiana-a French territory marked by geographic isolation, cultural diversity, and significant health inequalities-we examine both the common features shared by these roles and the meaningful distinctions embedded in their names. Across contexts, these workers occupy a similar structural position at the interface between communities and health systems, characterised by community embeddedness; a focus on prevention and access to care; and persistent tensions regarding remuneration, scope of practice, and professional recognition. At the same time, the diversity of denominations encodes variations in training, institutional affiliation, and underlying philosophies of engagement, particularly along the axes of community vs. system orientation, generalist vs. specialist mandate, and volunteerism vs. formal employment. While such distinctions are contextually meaningful, their multiplication contributes to fragmentation, limits comparability, and weakens the emergence of a shared professional identity. We argue that terminological proliferation functions as a substitute for institutional consolidation: in the absence of standardised training, stable employment frameworks, and clear professional recognition, naming becomes a site where these tensions are negotiated. Rather than multiplying labels, a more productive approach would combine a broad, inclusive category with a structured taxonomy of roles based on key dimensions such as training, function, and degree of integration into health systems. The case of French Guiana illustrates how diverse configurations of such roles can coexist within a single territory, while highlighting the need for clearer frameworks to support their recognition and sustainability.</p>","PeriodicalId":73088,"journal":{"name":"Frontiers in health services","volume":"6 ","pages":"1898370"},"PeriodicalIF":2.6,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13658854/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149186608","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":"Content validity of the Chinese version of the PRAP scale: a convergent parallel mixed-methods study.","authors":"Yulin Zhang, Yingwen Wang, Weijia Fu, Beibei Wang, Yanhong Zhang, Qiongfang Kang, Xiaobo Zhang, Ying Gu","doi":"10.3389/frhs.2026.1935953","DOIUrl":"10.3389/frhs.2026.1935953","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to evaluate the content validity of the Chinese-language version of the PRAP scale from comprehensive perspectives within the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) framework.</p><p><strong>Methods: </strong>We evaluated the content validity of the Chinese PRAP scale using COSMIN methodology in a convergent parallel mixed-methods design (August 2022-November 2023) at a tertiary children's hospital in Shanghai, with 57 content validity raters including nurses, social workers, and family caregivers. Quantitative (I-CVI, S-CVI/Ave) and qualitative data from semi-structured interviews were integrated.</p><p><strong>Results: </strong>The scale showed strong overall content validity based on the quantitative ratings (S-CVI/Ave = 0.92). Item 5 (\"Parent/caregiver stress\") showed the lowest relevance rating (I-CVI = 0.79). Qualitative feedback identified ambiguous phrasing in Items 4 and 5 and inconsistent interpretation of professional terminology.</p><p><strong>Conclusion: </strong>Despite uncertainties in comprehensibility identified by qualitative insights, the findings provide evidence supporting the content validity of the Chinese PRAP scale, while acknowledging that further psychometric evaluation is required.</p>","PeriodicalId":73088,"journal":{"name":"Frontiers in health services","volume":"6 ","pages":"1935953"},"PeriodicalIF":2.6,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13655085/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149169246","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":"Decision tree for improving the impact of equity-focused public health service delivery and research.","authors":"Cassandra Lane, Daniel Groombridge, Judith Byaruhanga, Tameka McFadyen, Luke Wolfenden","doi":"10.3389/frhs.2026.1948535","DOIUrl":"10.3389/frhs.2026.1948535","url":null,"abstract":"<p><strong>Introduction: </strong>An equity focus in public health service delivery and research is needed to address persistent health inequities. This requires not only redistribution of health resources and services to prioritised populations, but also attention to the process through which initiatives are selected, designed and implemented, and how these engage with and address the social determinants of health. Applying this in practice can be challenging, and there is limited practical guidance for public health organisations.</p><p><strong>Methods: </strong>We adapted a decision tree to support equity-focused public health service delivery and research, aimed at practitioners and researchers working to support the co-design and implementation of effective and socio-culturally responsive health initiatives for a known priority population within a defined public health focus area (e.g., tobacco cessation, physical activity, cancer screening). This tool was informed by the literature and iterative development with an interdisciplinary team of public health professionals, implementation scientists, and health equity academics.</p><p><strong>Results: </strong>The Equity-Focused Decision Tree consists of structured decision points and actions across three steps, underpinned by co-creation principles and ongoing local community engagement. Step 1 - <i>Identify or co-design and evaluate an initiative</i>: users integrate empirical and qualitative evidence to a) determine whether any existing initiative is both effective and suitable for the priority population; and b) where none exist, a new initiative is co-designed and evaluated. Step 2 - <i>Assess evidence-practice gaps</i>: users determine whether the initiative is being routinely implemented. Step 3 - <i>Identify implementation strategies</i>: users identify or co-design evidence- and community-informed implementation strategies that are responsive to the community's needs, values, and context.</p><p><strong>Conclusion: </strong>This decision tree provides a practical tool to guide public health organisations in applying an equity focus across the process of service delivery and research. It has the potential to advance equity by improving health outcomes for the priority population, and by contributing towards addressing the social determinants of health that underpin persistent health inequities.</p>","PeriodicalId":73088,"journal":{"name":"Frontiers in health services","volume":"6 ","pages":"1948535"},"PeriodicalIF":2.6,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13654963/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149170930","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":"Disability pension receipt five years after cancer diagnosis: a matched registry study of working-age cancer survivors in Norway.","authors":"Shahram Moradi, Steffen Torp, Roy Nielsen, Eliva Atieno Ambugo","doi":"10.3389/frhs.2026.1913581","DOIUrl":"https://doi.org/10.3389/frhs.2026.1913581","url":null,"abstract":"<p><strong>Objective: </strong>To examine receipt of partial or full disability pension (DP) five years after cancer diagnosis among working-age cancer survivors (CSs) in Norway and the associations of cancer-related and socioeconomic factors with DP receipt.</p><p><strong>Methods: </strong>Nationwide registry data included 11,188 individuals aged 30-55 diagnosed with first primary invasive cancer (2004-2008), all employed at diagnosis. CSs were matched to cancer-free controls at a 1:1 ratio based on age, sex, education, and employment at baseline. Conditional logistic regression estimated the association between cancer status and DP receipt. Additional analyses among CSs examined cancer type, cancer stage, and socioeconomic factors.</p><p><strong>Results: </strong>CSs had more than twice the odds of receiving DP compared with controls. Among CSs, advanced cancer stage and cancer type (e.g., respiratory, blood, and CNS-related cancers) were associated with higher odds of receiving DP, while skin cancer was associated with lower odds (compared to digestive organ cancers). Older age, lower education, lower income, and being unmarried were all associated with higher odds of receiving DP. Having young children (aged 0-5) versus none was associated with lower odds of DP, and no differences were observed by immigrant background.</p><p><strong>Conclusion: </strong>CSs had higher odds of receiving DP, particularly those with advanced cancer stage and certain cancer types. Socioeconomic disadvantages such as lower education or limited income were also associated with higher odds of receiving DP. These findings highlight the need for tailored occupational rehabilitation strategies that address both clinical and socioeconomic circumstances.</p>","PeriodicalId":73088,"journal":{"name":"Frontiers in health services","volume":"6 ","pages":"1913581"},"PeriodicalIF":2.6,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13649679/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149170446","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}