Frontiers in health services最新文献

{"title":"COVID-19 vaccine hesitancy in Ethiopia: a scoping review for equitable vaccine access.","authors":"Senait Aleamyehu Beshah, Jibril Bashir Adem, Mosisa Bekele Degefa, Melkamu Ayalew, Yohannes Lakew, Sileshi Garoma, Elizabeth Naa Adukwei Adote, Daniel Malik Achala, Grace Njeri Muriithi, Chinyere Ojiugo Mbachu, James Akazili, Chikezie Ifeanyi, Elias Asfaw Zegeye, Chijioke O Nwosu, John E Ataguba","doi":"10.3389/frhs.2025.1609752","DOIUrl":"10.3389/frhs.2025.1609752","url":null,"abstract":"<p><strong>Introduction: </strong>COVID-19 vaccines are crucial for preventing severe illness from the virus. Despite their effectiveness; vaccine hesitancy, unequal access, and economic disparities hinder vaccination programs across Africa, posing significant challenges in Ethiopia.</p><p><strong>Method: </strong>This scoping review followed the methodological guidelines outlined in the Joanna Briggs Institute Reviewer's and employed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses - Extension for Scoping Reviews (PRISMA-ScR) checklist and explanation to ensure transparency. To analyze the data, we developed tailored search strategies for key databases [HINARI, PubMed, Cochrane, African Journals Online (AJOL), and Science Direct] and gray literature sources. These strategies combined controlled vocabulary and relevant keywords. A descriptive thematic analysis was then employed to identify and categorize the various findings within the included studies. The results are presented in a narrative format, summarizing the key themes and providing a clear and comprehensive overview of the current evidence base.</p><p><strong>Results and recommendations: </strong>A review of 34 Ethiopian studies revealed significant COVID-19 vaccine hesitancy, with rates exceeding 50% in over 40% of the studies. The lowest hesitancy was found in adults from Addis Ababa (19.1%), while the highest rates were seen among healthcare workers in Oromia (69.7%) and pregnant women in Southwest Ethiopia (68.8%). Factors contributing to vaccine hesitancy in Ethiopia include being female, having only primary education, residing in rural areas, younger age, limited knowledge about the vaccine, reduced trust in authorities, and misperceptions about the risk of the virus. To address this challenge effectively, policymakers should prioritize interventions that build public trust, enhance awareness of the vaccine's benefits, and counter misinformation.</p>","PeriodicalId":73088,"journal":{"name":"Frontiers in health services","volume":"5 ","pages":"1609752"},"PeriodicalIF":2.7,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12444891/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145115234","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":"Fresh funds for moms: feasibility of a 12-week online food as medicine grocery prescription program for women with food insecurity and gestational diabetes.","authors":"Rachel Gillespie, Sara J Maksi, Joshua Bush, Cynthia Cockerham, Courtney T Luecking, Andrea L Deierlein, Heather Wasser, Alison Gustafson","doi":"10.3389/frhs.2025.1625558","DOIUrl":"10.3389/frhs.2025.1625558","url":null,"abstract":"<p><strong>Introduction: </strong>Pregnant women with food insecurity experience high rates of gestational diabetes mellitus (GDM). Food as medicine and grocery prescription (GPx) programs have been successful in increasing food access and managing chronic disease; however, they are often not implemented during pregnancy.</p><p><strong>Methods: </strong>This was a pilot study of Fresh Funds for Moms, an online grocery prescription (GPx) program. Pregnant women between 20 and 28 weeks' gestation were purposefully recruited from one large hospital system in an urban community in Kentucky. Eligibility included: positive screening for food insecurity; diagnosis of either GDM, type 2 diabetes, or hypertension; and live in a zip code with online grocery service delivery access. Women received $200 per month for 12 weeks (total of $600) for healthy food purchases on an online grocery platform.</p><p><strong>Results: </strong>A total of 1,163 women were initially screened; 20 women were referred to participate in the program and 14 completed the program. On average, women redeemed 96.1% of their grocery benefit throughout the pilot GPx program. Fruit and vegetable purchases increased 4% from months one to three (27%-31%), while the percentage of funds spent on meat food items decreased from 31% to 22% by the third month, and percentage spent on pantry items remained consistent month-to-month (4%). Qualitative findings highlight overall satisfaction, however, participants reported some transactional confusion when redeeming their funds on the online grocery platform and a desire for more variety when selecting food items for delivery. Blood glucose and blood pressure improved slightly, however no clinically meaningful changes in HgbA1c were observed.</p><p><strong>Discussion: </strong>This pilot study demonstrated the feasibility of implementing a GPx program in collaboration with clinical, research, and industry partners as a food as medicine intervention. Online GPx programs have the potential for improving healthy shopping habits among pregnant women. However, to improve screening, referral, and enrollment, a larger system approach is needed to meet patients' needs, warranting further investigation in larger, adequately powered studies.</p>","PeriodicalId":73088,"journal":{"name":"Frontiers in health services","volume":"5 ","pages":"1625558"},"PeriodicalIF":2.7,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12440972/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145088241","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":"Decades of failure to prevent harm to patients-where are we going wrong? A mixed methods study of the perspectives of health services staff across Australia and internationally.","authors":"Mia Bierbaum, Yinghua Yu, Charlotte J Molloy, Lorelle Bowditch, Paul M Salmon, Sandy Middleton, Jeffrey Braithwaite, Peter Hibbert","doi":"10.3389/frhs.2025.1645575","DOIUrl":"10.3389/frhs.2025.1645575","url":null,"abstract":"<p><strong>Context: </strong>Patient Safety Incident (PSI) reviews are undertaken frequently across health services in response to serious adverse events. This study investigated experiences and perceptions of healthcare professionals involved in incident review processes across four jurisdictions in Australia, alongside insights from international patient safety experts. These findings will inform the co-design of improvements to PSI reviews.</p><p><strong>Methods: </strong>Semi-structured interviews and focus groups were conducted, and participants completed an attitudinal and demographic survey. Inductive thematic analysis was conducted, and findings were deductively mapped against the Consolidated Framework for Implementation Research.</p><p><strong>Findings: </strong>Australian (<i>n</i> = 99) and international (<i>n</i> = 11) participants took part in one of 25 focus groups (<i>n</i> = 78) or 32 interviews. Most participants (<i>n</i> = 99) completed the survey. Nearly all survey participants agreed/strongly agreed that PSI reviews are valuable for improving patient safety (95%), particularly when human factors and contextual influences on performance (76%) are considered. Two-thirds of participants agreed that investigations help prevent PSI recurrence (68%), avoid unfair blame (67%), and support continuous improvement (61%). However, fewer participants felt recommendations are consistently accepted by organisations (58%) or are appropriately targeted within the healthcare system (57%). Key strengths and challenges of the PSI review process were identified across three themes<b>:</b> Selection of PSI Reviews; Reviews, Recommendations and Implementation; and Health Organisations and Wider System Influences. Key PSI review challenges included: limited capacity and engagement, high staff workloads, turnover, and burnout, as well as variable skills, and limited human factors and systems thinking experience across review teams. Despite strong efforts to reduce a punitive culture, resistance to reporting and blame persists across some hospitals. Participants highlighted a learned powerlessness when developing systems thinking-based recommendations, resulting in the development of weaker, less resource intensive recommendations. Limited sharing of learnings and feedback on review findings, and variable monitoring, evaluation and accountability of recommendation implementation were also common challenges.</p><p><strong>Conclusions: </strong>These findings have identified a need for system re-engineering of PSI reviews to address identified challenges and will inform the development of Best Practice Principles and a codesign of patient safety tactics for trial in-situ.</p>","PeriodicalId":73088,"journal":{"name":"Frontiers in health services","volume":"5 ","pages":"1645575"},"PeriodicalIF":2.7,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12436320/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145082568","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":"Incorporating the video communication assessment for error disclosure in residency curricula: a mixed methods study of faculty perceptions.","authors":"Emily Grossniklaus, Ann M King, Angelo E D'Addario, Karen Berg Brigham, Thomas H Gallagher, Thea G Musselman, Kendra Hester, Kathleen M Mazor, Andrew A White","doi":"10.3389/frhs.2025.1503922","DOIUrl":"10.3389/frhs.2025.1503922","url":null,"abstract":"<p><strong>Introduction: </strong>U.S. resident physicians are required to demonstrate competency in disclosing patient safety events to patients, including harmful errors. The Video-based Communication Assessment (VCA) is a novel tool that provides opportunities to practice and receive feedback on communication skills. VCA practice and feedback are associated with improvements in residents' error disclosure skills, but no research exists regarding faculty members' views on implementing the VCA in patient safety curricula. We sought to evaluate faculty members' views on using the VCA for teaching error disclosure communication in residency, and to identify barriers and facilitators to VCA adoption.</p><p><strong>Methods: </strong>Mixed methods study using a validated survey of Acceptability, Appropriateness, and Feasibility (AAF), and thematic content analysis of structured key informant interviews with faculty.</p><p><strong>Results: </strong>25 faculty completed both the AAF survey and interview. Overall, the faculty rated the VCA with a mean AAF score of 4.23 (out of 5). Analysis of the interviews identified case quality, relevancy, and fulfillment of a curricular void as attractive aspects of the tool, while feedback delays and content were identified as limitations. A major challenge to implementation included finding curricular time. Faculty anticipated the VCA would be useful for resident remediation and could be used in faculty coaching on error disclosure.</p><p><strong>Conclusion: </strong>The VCA seems to be an acceptable and feasible tool for teaching error disclosure; this finding warrants confirmation and testing in other specialties. Faculty members expected the VCA would be useful for both improving poor performance as well as informing faculty coaching, although these approaches remain untested. To facilitate adoption, faculty recommended protecting curricular time for VCA use and effectively communicating with residents about who will review their personal assessments and how the exercise will support their learning.</p>","PeriodicalId":73088,"journal":{"name":"Frontiers in health services","volume":"5 ","pages":"1503922"},"PeriodicalIF":2.7,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12425960/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145066283","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":"A multi-stakeholder multicriteria decision analysis for implantable medical devices assessment in China.","authors":"Yizhou Xu, Junjie Wan, Bin Wan, Haixia Ding","doi":"10.3389/frhs.2025.1650709","DOIUrl":"10.3389/frhs.2025.1650709","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to develop a standardized multicriteria decision analysis (MCDA) framework tailored for implantable medical devices in China, addressing the challenges of inconsistent evaluation processes under China's evolving healthcare financing policies.</p><p><strong>Methods: </strong>A mixed-methods design combining a discrete choice experiment (DCE) and MCDA was employed. Six criteria (clinical effectiveness, clinical safety, innovation, disease severity, implementation capacity, and cost) were identified through literature reviews and expert consultations. A DCE survey with 540 multi-stakeholder participants (decision-makers, HTA experts, clinicians, hospital administrators, and citizens) was conducted to derive criterion weights using mixed logit models. The framework was validated through a real-world case study assessing endoscopic linear staplers.</p><p><strong>Results: </strong>Clinical safety (35.45%) and cost (27.94%) emerged as the most critical criteria, followed by implementation capacity (16.56%) and clinical effectiveness (15.07%). Innovation (2.54%) and disease severity (2.44%) received minimal weight. The MCDA application demonstrated high inter-rater consistency (CV < 0.25).</p><p><strong>Conclusions: </strong>This study proposes a transparent, stakeholder-driven framework for evaluating implantable medical devices, specifically designed to support China's healthcare policies. The framework ensures that healthcare decisions are grounded in clinical effectiveness, safety, and long-term economic viability.</p>","PeriodicalId":73088,"journal":{"name":"Frontiers in health services","volume":"5 ","pages":"1650709"},"PeriodicalIF":2.7,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12426139/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145066285","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":"Nurses' compliance with infection control, safety measures, communication, and protocol adherence in operating rooms of governmental hospitals in the Gaza strip.","authors":"Mohammed A Abu Rahmah, Bothyna B ELssyed Etewa, Fatma Al'Haj Ahmad, Abdel Hamid El Bilbeisi","doi":"10.3389/frhs.2025.1657817","DOIUrl":"10.3389/frhs.2025.1657817","url":null,"abstract":"<p><strong>Background: </strong>This study assessed nurses' compliance with infection control, safety measures, communication, and protocol adherence in operating rooms of government hospitals in Gaza.</p><p><strong>Methods: </strong>A cross-sectional study was conducted in 2023 across the three main governmental hospitals in Gaza: Al Shifa Medical Complex, Nasser Medical Complex, and Gaza European Hospital. A census sampling method included 150 nurses working in operating rooms who met inclusion criteria. Data were collected using a structured, validated questionnaire covering demographics and six domains of patient safety based on the WHO Patient Safety Assessment Tool. Statistical analysis was performed using SPSS version 26, with significance set at <i>p</i>-value < 0.05.</p><p><strong>Results: </strong>Among 150 nurses (78% male, mean age 32.94 ± 7.3 years); most (71.4%) held a bachelor's degree; and 43.3% had specialized operating room training. Positive responses on sterilization and cleaning averaged 46.7%, highest at Al Shifa (51.8%). Key practices such as instrument transport in sealed trolleys (80.7%) and immediate cleaning post-procedure (83.3%) were well reported. Intraoperative precaution compliance was 73.3%, with high rates of proper hand scrubbing (84.7%) but lower adherence to checklist completion (65.3%). Immediate post-operative monitoring adherence was 68.7%, with oxygen saturation measurement (88%) and pain assessment (77.3%) rated highly. Communication satisfaction was 72.7%, though cooperation during patient positioning was only 46%. About 66.7% reported positive views on policies and training, yet 75.3% expressed a need for more patient safety education. A high incidence of adverse events was reported by 93.3%, with reluctance to document errors noted by 68%.</p><p><strong>Conclusion: </strong>This study highlights moderate compliance with infection control in Gaza Strip operating rooms but reveals significant gaps in protocol adherence, documentation, and error reporting. It highlights the need for better training, resource support, and a non-punitive safety culture. Policymakers and hospital leaders must prioritize these to improve surgical safety and patient care.</p>","PeriodicalId":73088,"journal":{"name":"Frontiers in health services","volume":"5 ","pages":"1657817"},"PeriodicalIF":2.7,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12425908/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145066389","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":"A values-driven academic affiliation between a public medical school and a private healthcare provider: exploring the perceptions of key opinion leaders.","authors":"Leon Du Preez, Farah Otaki, Timo Clemens, Suleiman Al-Hammadi, Adrian Stanley, Samuel B Ho, Paddy Kilian, Pietie Loubser, Riad Bayoumi, Mutairu Ezimokhai, Barry Bedford, Tarek Fathey, Reem AlGurg, Hanan Al Suwaidi, Amer A Sharif, Alawi A Alsheikh-Ali","doi":"10.3389/frhs.2025.1655759","DOIUrl":"10.3389/frhs.2025.1655759","url":null,"abstract":"<p><strong>Introduction: </strong>In an Academic Health System model where university and clinical care institutions are separate entities, robust agreements are needed for effective working relationships among the involved institutions. There is paucity in the literature around reports of such affiliations, especially those relating to public private partnerships. Accordingly, the overall purpose of this study is to explore the perception of key opinion leaders about the development of a values-driven affiliation between a public medical school and a private healthcare provider in the first integrated Academic Health System in Dubai, United Arab Emirates, namely: Dubai Health. The process of developing the respective affiliation is based on the principles of action research. It involved ongoing cycles of planning, acting, observing, and reflecting.</p><p><strong>Methods: </strong>This study relied on a qualitative phenomenological research design, where 18 primary stakeholders, who played an active role in making the affiliation, were given the option of providing their feedback either in writing, using a tailor-made questionnaire, or in the form of a semi-structured interview. Constructivist epistemology constituted the basis of the entailed interpretive qualitative analysis, which followed the six-step analysis approach initially introduced by Braun and Clarke (2006).</p><p><strong>Results: </strong>The qualitative analysis led, as per this study's conceptual framework: \"Public Private Affiliation Journey\", to two interconnected themes, namely: Key Milestones and Driving Forces. Within Key Milestones, seven sequential categories were identified: Observing a triggering need, Finding a good match, Seizing the opportunity, Arriving at a common ground, Looking ahead, Venturing for the right reasons, and Reaping the benefits. Within the second theme: Driving Forces, the following three categories were identified: Aspiring for success, Leveraging human qualities, and Doing things the right way.</p><p><strong>Discussion: </strong>This study showed that there is a latent potential in forming public private partnerships that can enable the formation and development of Academic Health Systems. It also showed how the guidelines of action research can be set as the basis of the process of partnership formation, and how following those guidelines in such an endeavor maximizes value for all. In addition, it clearly brought forth the importance of having a robust governance structure with committed and engaged leadership, and clear communication channels, and of equipping the physicians with the skills needed to be effective educators. Lastly, this study introduced the \"Public Private Affiliation Journey\" conceptual framework, which can be deployed in \"federated\" Academic Health Systems worldwide to increase the chances of success of public private partnerships and to maximize the value attained through them.</p>","PeriodicalId":73088,"journal":{"name":"Frontiers in health services","volume":"5 ","pages":"1655759"},"PeriodicalIF":2.7,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12423040/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145066330","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 quality improvement in tertiary care hospital before and after NABH accreditation: a systematic review.","authors":"Deepika Kanyal, Babaji Ghewade","doi":"10.3389/frhs.2025.1654514","DOIUrl":"10.3389/frhs.2025.1654514","url":null,"abstract":"<p><strong>Background: </strong>The National Accreditation Board for Hospitals and Healthcare Providers (NABH.) accreditation process aims to elevate the quality of healthcare services through an impartial, external peer evaluation of an organization's performance. This study compares NABH. quality indicators in a tertiary care hospital before and after accreditation, assessing changes in patient care, hospital management, and staff performance.</p><p><strong>Methods: </strong>A systematic review was conducted following PRISMA guidelines. Literature was searched across PubMed, Scopus, Google Scholar, and the Cochrane Library from August 2023 to January 2024. Keywords included \"NABH. accreditation and hospital quality,\" \"Accreditation in Indian hospitals and patient safety,\" and \"Tertiary care hospital before and after accreditation.\" Boolean operators, synonyms, and related terms were used to ensure comprehensive retrieval. Independent reviewers screened studies, and risk of bias assessment was performed using the Cochrane Risk of Bias Tool.</p><p><strong>Results: </strong>The study highlights significant improvements in hospital quality indicators following NABH accreditation. Hospital-acquired infection rates decreased, with infection control compliance improving by 40%. Operational efficiency improved with a 20% reduction in discharge delays and a 15% increase in documentation accuracy. Patient satisfaction scores rose by 25%, and structured policies enhanced service quality by 30%. Additionally, 85% of hospital staff reported higher job satisfaction. Statistical analysis confirmed significant differences in compliance rates (<i>p</i> < 0.05) and patient care metrics (<i>p</i> < 0.01). Despite initial implementation challenges due to resource constraints, the study underscores the need for continuous monitoring and reinforcement of accreditation standards to sustain these improvements.</p><p><strong>Conclusion: </strong>NABH accreditation improves patient safety, lowers infection rates, and boosts overall productivity. The structured framework encourages continuous improvement, but institutional commitment and ongoing oversight are necessary for long-term sustainability.</p>","PeriodicalId":73088,"journal":{"name":"Frontiers in health services","volume":"5 ","pages":"1654514"},"PeriodicalIF":2.7,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12417434/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145042566","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":"Impact of hospital complaint handling on promoting high-quality development of hospitals via an emotional language analysis model: a case study of a tertiary hospital service center in Quanzhou city, Fujian province.","authors":"Caijiao Zheng, Yi Zhang, Xiaolong Lian, Jinxiu Ke, Hongxia Chen, Yiwen Chen","doi":"10.3389/frhs.2025.1610004","DOIUrl":"10.3389/frhs.2025.1610004","url":null,"abstract":"<p><strong>Background: </strong>In the healthcare service industry, patient complaints serve not only as a critical metric for assessing hospital service quality but also as a fundamental driver of high-quality hospital development. Through a systematic analysis of patients' perceptions, opinions, and emotional responses to hospital management within the complaint-handling process.</p><p><strong>Methods: </strong>Therefore, this paper aims to develop a hospital complaint-handling analysis model to enhance public satisfaction with greater precision. First, complaint data from hospitals spanning January to December 2022-2024 was preprocessed using data cleaning, mechanical compression, word segmentation, and stop-word filtering techniques. Second, the DISC behavioral language model was employed to analyze key indicators, including hospital compensation frequency, total compensation amounts, patient appeal rates, complainants' satisfaction with the resolution process, and their overall satisfaction with complaint outcomes. Finally, a sentiment analysis model and an improved KANN-DBSCAN clustering model were applied to complaint data to precisely identify sentiment-related keywords and assess the intensity of negative emotions, providing hospitals with targeted improvement recommendations.</p><p><strong>Results: </strong>This study applied the DISC behavioral model to medical complaints. DISC-based text analysis enabled tailored responses. Among 334 intervention and 341 control cases, satisfaction 93.39%, was higher in the intervention group 83.24%, indicating improved complaint resolution through behavior-informed communication strategies.</p><p><strong>Conclusions: </strong>By analyzing patients' psychological needs and expectations, this study aims to minimize financial compensation and reduce patient appeals while enhancing overall complaint resolution satisfaction, which provides medical institutions with a more comprehensive, effective, and personalized complaint-handling strategy while simultaneously improving patients' healthcare experiences.</p>","PeriodicalId":73088,"journal":{"name":"Frontiers in health services","volume":"5 ","pages":"1610004"},"PeriodicalIF":2.7,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12417483/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145042522","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":"Leveraging generative AI to simulate mental healthcare access and utilization.","authors":"Cortney VanHook, Daniel Abusuampeh, Jordan Pollard","doi":"10.3389/frhs.2025.1654106","DOIUrl":"10.3389/frhs.2025.1654106","url":null,"abstract":"<p><strong>Purpose: </strong>This article examines how generative artificial intelligence (AI) can simulate, analyze, and enhance mental health care journeys for individuals from diverse backgrounds, supporting improved access, personalization, and outcomes.</p><p><strong>Design/methodology/approach: </strong>An AI-generated case study of Marcus Johnson, a 24-year-old Black software developer in Atlanta, models the interplay of personal, cultural, and systemic factors affecting mental health care access. The analysis integrates Andersen's Behavioral Model, Penchansky and Thomas's Dimensions of Access, and Measurement Based Care (MBC) to systematically identify barriers, facilitators, and opportunities for data-driven intervention and tailored care.</p><p><strong>Findings: </strong>The case study demonstrates that generative AI simulations, especially when combined with MBC, can replicate real-world complexities, inform clinical decision-making, and personalize interventions through ongoing assessment, symptom monitoring, and collaborative planning. Telehealth, flexible scheduling, and cultural competence are highlighted as critical for bridging access gaps and improving outcomes.</p><p><strong>Originality/value: </strong>This work is among the first to synthesize leading access-to-care models, MBC, and generative AI to simulate and improve mental health care pathways. The approach offers a novel framework for educators, clinicians, and system designers to address the full spectrum of access challenges and clinical needs in contemporary populations.</p><p><strong>Practical implications: </strong>Generative AI, anchored in evidence-based frameworks, enables mental health professionals and trainees to test and refine care strategies in a risk-free environment, promoting more equitable, responsive, and effective mental health systems for all.</p>","PeriodicalId":73088,"journal":{"name":"Frontiers in health services","volume":"5 ","pages":"1654106"},"PeriodicalIF":2.7,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12417535/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145042554","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}