Frontiers in health services最新文献

{"title":"From clicks to connection: designing nursing content within an electronic health record that reflects person-centred relationships and choices.","authors":"Michele Hardiman, Judith Watkin, Winifred O'Neill, Sinead Hanley","doi":"10.3389/frhs.2026.1781450","DOIUrl":"https://doi.org/10.3389/frhs.2026.1781450","url":null,"abstract":"<p><p>Electronic Health Records (EHRs) are central to healthcare transformation, promising improved access to information, decision support, and safer care delivery. It acts as a central repository of all information pertinent to a person receiving treatment and is easily accessible. This paper presents a an experiential perspective and follow up from a nursing team who led the design, development, and evaluation of a person-centred electronic nursing record within an acute hospital setting. Guided by the Person-centred Practice Framework and participatory approaches to workplace culture development, the team collaborated with informatics specialists to redesign more than 120 assessments, diagnoses, interventions and outcomes that better reflect nursing values, patient choice, and local workflows. Through continuous attention to organisational structures, facilitative processes, and emerging cultural patterns, nurses achieved greater alignment between digital documentation and the realities of bedside practice. Evaluation data demonstrated improved nurse engagement with the EHR, enhanced therapeutic relationships, reduced documentation burden, and strengthened person-centred cultures across the organisation. These findings highlight the critical role of nurses in digital transformation and the need for meaningful input into EHR content design and governance. We argue that digital nursing documentation must reflect the complexity and relational nature of nursing practice, rather than prioritising technical tasks or disease-focused content. As national and international EHR initiatives advance, nursing leadership must influence system procurement, content customisation, and ongoing evaluation to ensure that digital records uphold professional values and support compassionate, holistic, person-centred care.</p>","PeriodicalId":73088,"journal":{"name":"Frontiers in health services","volume":"6 ","pages":"1781450"},"PeriodicalIF":2.7,"publicationDate":"2026-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13057456/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147647480","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":"Social health insurance and professional ethics in Romania: between legal framework and medical integrity.","authors":"Roxana Elena Mirică, Ioana Soare","doi":"10.3389/frhs.2026.1749779","DOIUrl":"https://doi.org/10.3389/frhs.2026.1749779","url":null,"abstract":"<p><strong>Background: </strong>Romania's social health insurance system is based on the Bismarck model and aims to provide universal healthcare access through compulsory contributions. While financing and institutional design have been widely studied, the ethical responsibilities of physicians, particularly social insurance physicians, remain under-explored.</p><p><strong>Objective: </strong>This study analyzes Romania's social health insurance system through an integrated institutional and ethical lens, focusing on social insurance physicians who operate at the interface of clinical assessment and social protection eligibility.</p><p><strong>Methods: </strong>A structured narrative review was conducted, synthesizing national legislation, international ethical frameworks (Declaration of Geneva, International Code of Medical Ethics), peer-reviewed literature (2010-2025), and comparative analyses with European health insurance models. The analysis identified systemic challenges, including underfunding, workforce migration, and demographic pressures, and examined their impact on professional ethics.</p><p><strong>Results: </strong>Romania ensures broad formal coverage, yet persistent challenges-underfunding, regional disparities, informal payments, and physician shortages-create ethical tensions for social insurance physicians. Comparative analysis shows that other European countries (Germany, France, Netherlands) mitigate such pressures through stronger institutional safeguards, higher funding, and protected professional autonomy.</p><p><strong>Conclusion: </strong>This study contributes to health services research by conceptualizing ethical vulnerability in resource-constrained insurance systems and linking institutional structures to professional autonomy, fairness, and system resilience. Findings highlight the need to strengthen ethical frameworks, safeguard physician independence, and align institutional reforms with ethical governance to ensure transparent, equitable, and resilient social health insurance systems.</p>","PeriodicalId":73088,"journal":{"name":"Frontiers in health services","volume":"6 ","pages":"1749779"},"PeriodicalIF":2.7,"publicationDate":"2026-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13057486/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147647481","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 theory and practice: the core components guide for rigorous quality improvement design.","authors":"Paul Howard, Jafet Arrieta, Chelsey Leruth, Kate Bones, Rebecca Steinfield, Johanna Figueroa, Sonya Panjwani Olaya, Pierre Barker","doi":"10.3389/frhs.2026.1751580","DOIUrl":"https://doi.org/10.3389/frhs.2026.1751580","url":null,"abstract":"<p><p>Quality improvement (QI) methods have been used extensively to support the delivery of safe, timely, effective, equitable, and cost-effective health care. While QI initiatives have demonstrated benefits, critical gaps in design and implementation undermine their impact. Systemic reviews and expert commentaries point to recurring challenges, including limited understanding and appreciation of the system in which the work takes place; poorly articulated aims; absence of guiding content theories for scalable implementation; weak implementation strategies; inadequate mechanisms for measurement, evaluation, and learning; and insufficiently structured approaches to communication and dissemination. These gaps limit learning, impact, replication, sustainability and scalability. To address these gaps, the Institute for Healthcare Improvement (IHI) developed the Core Components Guide, a practical framework for designing, implementing, and evaluating QI initiatives. Grounded in Deming's System of Profound Knowledge and the Model for Improvement, the guide includes six interrelated components: System Understanding, Improvement Aim, Measurement, Evaluation and Learning, Content Theory, Execution Theory, and Dissemination and Communication. Together, these components provide a structured approach to align interventions with context, clarify program theory, and embed iterative learning cycles. This manuscript introduces the Core Components, illustrates their application through a case study, and shares lessons learned from operationalizing the guide across diverse settings. By integrating improvement and implementation science principles, the Core Components Guide strengthens design, promotes fidelity, and increases the potential for impact, replication, scale, and sustainability of QI initiatives. This Guide offers actionable strategies for QI leaders and policymakers to build stronger foundations for improvement, evaluation, and dissemination.</p>","PeriodicalId":73088,"journal":{"name":"Frontiers in health services","volume":"6 ","pages":"1751580"},"PeriodicalIF":2.7,"publicationDate":"2026-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13057544/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147647446","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":"Navigating paradox in child welfare: implications for improvement science in complex human service systems.","authors":"Christina Evaldsson, Sofia Kjellström","doi":"10.3389/frhs.2026.1767083","DOIUrl":"https://doi.org/10.3389/frhs.2026.1767083","url":null,"abstract":"<p><strong>Introduction: </strong>Improvement science emphasizes the need to understand and enhance quality in complex service systems. While the field primarily has developed within healthcare, its expansion into social care requires deeper engagement with how quality is understood and enacted in practice. This study addresses this need by exploring how child welfare professionals in Sweden understand and enact \"quality\" in their everyday work with implications for improvement science in complex human service systems.</p><p><strong>Methods: </strong>The study employed a qualitative, practice-oriented, and interactive research design. The data consisted of 28 semi-structured interviews with professionals in child welfare, an analysis seminar, and documents (such as a quality management system and quality reports). An inductive content analysis was conducted, constructing themes through systematic interpretation rather than predefined frameworks.</p><p><strong>Results: </strong>The analysis identified two coexisting logics of quality: one emphasizing uniformity, the other emphasizing responsiveness to uniqueness. The findings show how professionals move between these logics as tensions become salient in daily practice.</p><p><strong>Discussion: </strong>By conceptualizing quality as a paradoxical construct, the study highlights how quality in child welfare is enacted through the ongoing negotiation of multiple logics, with implication for improvement science. The findings align with previous research suggesting that sustainable improvement involves the interplay of generalizable and contextual knowledge, and that paradoxes in organizational life shape conditions for learning and improvement.</p><p><strong>Conclusion: </strong>Quality in child welfare is not a fixed attribute but a negotiated phenomenon, shaped by persistent tensions between uniformity and responsiveness. Recognizing these paradoxes invites reflection on how improvement science engages with quality in complex human service systems, particularly in relation to the interplay between codified standards and professional judgment.</p>","PeriodicalId":73088,"journal":{"name":"Frontiers in health services","volume":"6 ","pages":"1767083"},"PeriodicalIF":2.7,"publicationDate":"2026-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13057446/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147647400","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":"Assessment of knowledge, attitude, and practice regarding diabetes among patients with type 2 diabetes in Hunan province, China: a cross-sectional study.","authors":"Guiyan Chen, Ning Gao, Jianwei Huang, Linhua Pi","doi":"10.3389/frhs.2026.1791049","DOIUrl":"https://doi.org/10.3389/frhs.2026.1791049","url":null,"abstract":"<p><strong>Background: </strong>Type 2 diabetes mellitus (T2DM) has become a public health crisis in China, particularly in rural areas, leading to significant impairment of quality of life and premature death. However, little is known about the level of knowledge, attitude, and practice (KAP) required for diabetic patients for effective management and prevention of complications. This study aimed to assess the KAP level of patients with T2DM and identify the associated factors in Central China.</p><p><strong>Methods: </strong>A cross-sectional study was conducted using self-administered KAP questionnaires among patients with T2DM recruited from 12 township health centers. KAP levels were determined by calculating the scores, and the association between respondents' characteristics and KAP outcomes was evaluated using chi-square tests and Mann-Whitney <i>U</i>-tests, as appropriate.</p><p><strong>Results: </strong>In total, 259 diabetic patients completed the survey. Overall, despite adequate knowledge and positive attitudes toward T2DM, there were substantial gaps in practices. The respondents scored 13.09 out of 17points on the knowledge subscales, 3.88 out of 4 on the attitude subscales, and 4.96 out of 12 on the practice subscales. Educational attainment, health insurance type, diabetic complications, and current medical treatment pattern were significant predictors of knowledge. Educational attainment, health insurance type, diabetic complications, and comorbidities were significant predictors of attitudes. Educational attainment and marital status affected respondents' practices significantly.</p><p><strong>Conclusions: </strong>Despite adequate knowledge and positive attitudes toward T2DM, there were substantial gaps in diabetic practices. These findings highlight the urgent need for action from relevant health authorities and policymakers to improve diabetic practices among Chinese patients with T2DM in rural China.</p>","PeriodicalId":73088,"journal":{"name":"Frontiers in health services","volume":"6 ","pages":"1791049"},"PeriodicalIF":2.7,"publicationDate":"2026-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13055530/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147640737","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":"Supporting complex mental health care and services research today and beyond: a mini-review of real-world evidence strategies and informed approaches.","authors":"Rachele M Hendricks-Sturrup, Fraser W Gaspar","doi":"10.3389/frhs.2026.1777597","DOIUrl":"https://doi.org/10.3389/frhs.2026.1777597","url":null,"abstract":"<p><p>Global mental health needs are escalating, yet few people with mental disorders receive effective care, underscoring the need for robust real-world evidence (RWE) to guide system transformation. Real-world data (RWD)-such as electronic records, claims, patient-reported outcomes, and digital sources-can capture the complexity of mental health care delivery beyond trials but remain underused. In this mini-review, we discuss methodological and infrastructural priorities for leveraging RWD to improve mental health services research and care. We describe recent peer-reviewed studies that have used RWD to examine complex mental health care and associated outcomes, focusing on applications of artificial intelligence and machine learning (AI/ML) and on approaches that enhance validity and reproducibility. Many recent studies report the use of AI/ML to identify study populations, extract unstructured clinical information, or predict treatment patterns, while others report the use of RWD to characterize trajectories, service use, and costs. Building on these examples, we propose two urgent actions: (1) adopt relevant, reliable, and routine RWD curation, transformation, and analysis strategies-including target trial emulation for causal inference-and (2) strengthen mental health care data systems through standardization, harmonization, and interoperability. To promote transparency, we highlight protocol and reporting tools (e.g., HARPER, ATRAcTR, TARGET) and recommend registration of RWE studies. Collectively, these advances can enable high-quality, patient-centered RWE that better reflects real-world mental health care and informs more equitable, effective services.</p>","PeriodicalId":73088,"journal":{"name":"Frontiers in health services","volume":"6 ","pages":"1777597"},"PeriodicalIF":2.7,"publicationDate":"2026-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13055558/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147640724","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":"Cost-effectiveness of degarelix versus LHRH agonists in prostate cancer: a systematic review.","authors":"Wei Wang, Sisi Li, Wenxuan Liu, Xiaoyan You, Yang Liu, Xianying Wang","doi":"10.3389/frhs.2026.1608532","DOIUrl":"https://doi.org/10.3389/frhs.2026.1608532","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;The escalating incidence of prostate cancer poses a significant global public health challenge. Optimal utilization of resources is crucial for the effective deployment of funds among the diverse and emerging treatment options for managing prostate cancer. This systematic review aims to offer insights and serve as a reference for pharmacoeconomic studies related to the use of degarelix and luteinizing hormone-releasing hormone (LHRH) agonists in the treatment of prostate cancer.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We conducted a comprehensive search in databases including Embase, PubMed, the Cochrane Library, CNKI, Web of Science, Scopus, and the Tufts CEA Registry to identify cost-effectiveness studies on the use of degarelix and LHRH agonists in the treatment of prostate cancer, spanning from the inception of these databases up to December 30, 2025. Two independent reviewers sequentially examined titles, abstracts, and full-text articles, applying predefined inclusion and exclusion criteria to select studies for data extraction. Any disagreements were resolved through discussion until a consensus was reached. The quality of the included studies was evaluated using the Quality of Health Economic Studies and Consolidated Health Economic Evaluation Reporting Standards. Relevant data were then summarized and comparatively analyzed, focusing on aspects such as the model framework, model parameters, and uncertainty analysis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 13 studies were ultimately incorporated, with an overall high quality but significant methodological variations among them. Five studies compared degarelix with leuprorelin, goserelin, or triptorelin; four compared triptorelin to goserelin or leuprorelin; one study evaluated leuprorelin acetate in a 6-month depot formulation vs. a 3-month depot; two compared leuprorelin to goserelin and triptorelin; and one study assessed radiotherapy vs. radiotherapy plus goserelin. Eight studies employed the Markov model, with time horizons spanning from 1 year to 30 years. The majority of the studies (&lt;i&gt;n&lt;/i&gt; = 7) conducted cost-effectiveness analyses, and most were based in developed countries (&lt;i&gt;n&lt;/i&gt; = 7). Degarelix was deemed cost-effective in the United States, United Kingdom, and China. Additionally, 6-month depot LHRH agonists were found to be more cost-effective than their monthly or 3-monthly counterparts.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;From a societal perspective, the evidence suggests that degarelix may be a cost-effective option for patients with prostate cancer. All assessments of LHRH agonists are of high quality. Among the three LHRH agonists evaluated, the 6-month depot formulation of triptorelin may be a cost-effective option in certain settings. In clinical practice, the evaluation of a drug should comprehensively consider its efficacy, adverse effects, cost-effectiveness, and overall patient survival. The evidence is predominantly derived from high-i","PeriodicalId":73088,"journal":{"name":"Frontiers in health services","volume":"6 ","pages":"1608532"},"PeriodicalIF":2.7,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13050778/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147635148","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":"Relationship between compassion fatigue, medical narrative ability, and retention intention among nurses: a cross-sectional multi-center study.","authors":"Fengju Wu, Yanjia Li, Jue Wu, Limei Zhang, Guoting Ma, Shaoping Wu, Yanli Hu","doi":"10.3389/frhs.2026.1718055","DOIUrl":"https://doi.org/10.3389/frhs.2026.1718055","url":null,"abstract":"<p><strong>Background: </strong>In recent years, due to the increase in care demands caused by population aging and the rise in nurse-patient conflicts, the retention intention of nurses has become an urgent global issue, as high turnover rates pose significant challenges to healthcare systems around the world. Therefore, this study will explore nurses' retention intention and the associated factors.</p><p><strong>Methods: </strong>This multi-center cross-sectional study recruited 1,831 nurses from eight hospitals across China between January and February 2024 through convenience sampling. Data collection was conducted using online surveys. The questionnaire was divided into four sections: the sociodemographic questionnaire, the Chinese Questionnaire for Nurse Intention to Remain Employed (C-QNIRE), the Medical Narrative Ability Scale (MNAS), and the Chinese version of Compassion Fatigue Short Scale (C-CF-Short Scale). We utilized descriptive statistics, normality test, one-way ANOVA, <i>t</i>-tests, Pearson correlation analysis, and multiple linear regression analysis.</p><p><strong>Results: </strong>The results of this study showed that the total score of nurses' retention intention was 22.79 ± 3.71. The Multiple linear regression results showed that compassion fatigue (<i>β</i> = -0.334, <i>p</i> < 0.001), medical narrative ability (<i>β</i> = 0.250, <i>p</i> < 0.001), age (46-60 years) (<i>β</i> = 0.143, <i>p</i> < 0.001), age (41-45 years) (<i>β</i> = 0.121, <i>p</i> < 0.001), age (36-40 years) (<i>β</i> = 0.107, <i>p</i> < 0.001), age (31-35 years) (<i>β</i> = 0.093, <i>p</i> < 0.001), working week (>50 h) (<i>β</i> = -0.096, <i>p</i> < 0.05), working week (46-50 h) (<i>β</i> = -0.071, <i>p</i> < 0.05), working week (40-45 h) (<i>β</i> = -0.070, <i>p</i> < 0.05), how many night shifts a month (>8) (<i>β</i> = -0.062, <i>p</i> < 0.05) were the main associated factors of nurses' retention intention, explaining 27.0% of the total variation.</p><p><strong>Conclusion: </strong>This study indicated that nurses demonstrate a moderate retention intention. Nursing administrators and educators should address this issue by proactively introducing strategies to reduce compassion fatigue and improve narrative medicine ability among nursing staff. Such initiatives can positively impact nurses' retention intention, thereby reducing the turnover of skilled nursing personnel. This is essential for effective management of nursing human resources and enhancing the overall quality of nursing care.</p>","PeriodicalId":73088,"journal":{"name":"Frontiers in health services","volume":"6 ","pages":"1718055"},"PeriodicalIF":2.7,"publicationDate":"2026-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13047137/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147624244","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":"Evaluating Australia's \"MyMedicare\" voluntary patient registration system: the prospective evaluation of patient registration study protocol.","authors":"Reema Harrison, Ashfaq Chauhan, Rebecca Mitchell, Smriti Raichland, Gaston Arnolda, Jeffrey Braithwaite, Johanna I Westbrook, Elizabeth Manias, Janani Mahadeva, Bronwyn Newman, Ramya Walsan, Kate Churruca, Sam Ricketts, Ricki Spencer, Mashreka Sarwar, Jeffrey Liang, Deborah Pallavicini, Dalal Dawood Baumgartner, Kim Bowen, Donna Gillies, Charbel Badr, Konrad Kangru, Ai-Vee Chua, Louise Hardy, Sarah Judd-Lamm, Kirsten Moore, Lily Edwards, Sanjyot Vagholkar","doi":"10.3389/frhs.2026.1746024","DOIUrl":"https://doi.org/10.3389/frhs.2026.1746024","url":null,"abstract":"<p><strong>Background: </strong>Managing the burden of chronic and complex disease is a global priority for health service delivery. Initiatives that aim to improve care integration and continuity to optimise health care utilisation, efficiency and outcomes are a priority. Patient registration with a general practice or practitioner has been adopted in multiple countries to promote continuity of care. This program of work will provide novel, critical evidence of the implementation of the Australian \"MyMedicare\" voluntary patient registration scheme, and the associated outcomes within its first years.</p><p><strong>Methods: </strong>Three workstreams will address five research objectives. Methods comprise analyses of longitudinal observational administrative health data (Workstream 1), qualitative interviews and quantitative surveys (Workstream 2) and analysis of linked general practice and health administrative data (Workstream 3). Primary outcomes are the number and demographics of patients registered in the MyMedicare scheme, implementation outcomes including feasibility and acceptability of registering, cost to practices associated with registering patients, and early impacts in the extent to which registration is associated with changes in health service utilisation, health outcomes and continuity of care.</p><p><strong>Conclusions: </strong>By evaluating over five years, the proposed research provides ample opportunity for people to have registered in order to assess, the process of registration, the effects of MyMedicare incentives, and the scheme's impact on continuity of care and health outcomes. The resulting evidence will contribute to national policy and international literature on the application of patient registration models to promote health service delivery and outcomes in the context of an aging population with escalating chronic and complex disease burdens.</p>","PeriodicalId":73088,"journal":{"name":"Frontiers in health services","volume":"6 ","pages":"1746024"},"PeriodicalIF":2.7,"publicationDate":"2026-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13044130/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147624224","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":"Characterization of collaborative management paths for public health at the county-level government in China: 3 cases based on fsQCA.","authors":"Jiangping Fu, Rui Hu, Bing Cao, Zhi Sun","doi":"10.3389/frhs.2026.1797149","DOIUrl":"https://doi.org/10.3389/frhs.2026.1797149","url":null,"abstract":"<p><strong>Background: </strong>County-level governments (CLG) are the basic organizational units of China's administrative power. The collaborative management paths (CMP) for public health at the CLG carry a variety of pressures and are responsible for coordinating the allocation of resources, and need to be well developed in terms of their capacity structure.</p><p><strong>Method: </strong>This study defines the CMP of CLG in public health as six variables of policy resource: configuration capability, perception capability, insight capability, integration capability, learning capability, and innovation capability. This study incorporates the fsQCA algorithm to explore the non-linear relationship between the collaborative management capabilities of the CMP of CLG in public health and policy resources.</p><p><strong>Results: </strong>A configuration of the CMP of CLG for public health was identified (solution coverage 36.67%, solution consistency 98.24%). The CLG's CMP has full-time-phase characteristics, i.e., the diversion management time-phase is characterized by conventional and non-conventional management time-phase groupings, but the non-conventional management time-phase does not have a bottleneck level. CLG's CMP has 3 core elements (Integration, Learning, and Perception Capabilities) and 2 supporting elements (Innovation and Insight Capabilities). The bottleneck level analysis of CLG's CMP resulted in a 10% level of perceived capacity being required to achieve a 60% level of configured capacity. The sensitivity test of the CMP for CLG suggests that the pathway is robust.</p><p><strong>Conclusion: </strong>This study presents a framework for observing/interpreting the results of CLG as a managerial behavior (policy resource management) at the grassroots level of government from the perspective of CMP.</p>","PeriodicalId":73088,"journal":{"name":"Frontiers in health services","volume":"6 ","pages":"1797149"},"PeriodicalIF":2.7,"publicationDate":"2026-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13044139/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147624948","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}