BMC Health Services Research最新文献

{"title":"Shared practices among primary health care workers: A time-motion study.","authors":"Talita Rewa, Geisa Colebrusco de Souza Gonçalves, Andrea Liliana Vesga Varela, Valéria Marli Leonello, Marina Peduzzi, Leticia Yamawaka de Almeida, Lorrayne Belotti, Debora Bernardo da Silva, Daiana Bonfim","doi":"10.1186/s12913-025-12439-9","DOIUrl":"https://doi.org/10.1186/s12913-025-12439-9","url":null,"abstract":"<p><strong>Background: </strong>Shared activities by health workers in meeting health needs are crucial to improve the health population, patient experience, quality of life of health teams members and the effectiveness of care.</p><p><strong>Objective: </strong>To identify the activities shared by Primary Health Care (PHC) team workers, whether multiprofessional or uniprofessional.</p><p><strong>Method: </strong>A descriptive study was, thus, carried out, based on the time-motion technique, in São Paulo-Brazil. Data collection was carried out from 2021 to 2022, through direct observations of workers, family health teams (FHT), oral health teams (OHT) and multiprofessional teams (MultiT). The frequency rates of both activities and time of shared practices and the distribution of workers involved in information exchanges were considered.</p><p><strong>Results: </strong>A total of 93 workers were observed, recording 21,936 activities (157,653 minutes). Of these, 72.90% were individual activities and 27.10%, shared (36.1% uni-professional and 63.9% multiprofessional). Shared activities represented 26.26% of the time. Dentists presented 60.8% of their activities in the shared modality, uni-professionally (99.26%). Concerning FHT, nurses were most dedicated to shared practices (33.09%) and exchanged information the most with others. According to team practices, the greatest amount of time dedicated to shared practices was spent by FHT (80%), followed by MultiT (71%) and OHT (65%).</p><p><strong>Conclusion: </strong>Multiprofessional work in PHC is evident as a precursor to interprofessional practice. In this sense, studies and reflections on the way in which PHC indicators have been monitored and evaluated, which mainly refer to individual activities, are required.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"317"},"PeriodicalIF":2.7,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143498810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of deans in implementing smoke-free campus policies: the case of medical schools in France.","authors":"Diane Geindreau, Anne Girault, Karine Gallopel-Morvan","doi":"10.1186/s12913-025-12415-3","DOIUrl":"https://doi.org/10.1186/s12913-025-12415-3","url":null,"abstract":"<p><strong>Background: </strong>Smoke-free campus (SFC) policies prohibit smoking and vaping on all university grounds and for all users. The literature on SFC shows that these policies reduce exposure to secondhand smoke and increase smoking cessation. Engagement from high-level leaders has been proven to be a key determinant in the SFC implementation process, but their attitudes toward SFC has rarely been investigated, and only in the USA. The aim of this research is to analyze deans' perceptions of SFC in medical schools in France, where smoking prevalence remains high despite broad awareness of the harms of tobacco.</p><p><strong>Methods: </strong>We used semi-structured interviews to explore medical school deans' perceptions of SFC implementation in France. Between October 2022 and January 2024, we interviewed 31 deans and two associate-deans, representing 31 out of the 35 medical schools in mainland France. Interviews were transcribed and the results were thematically analyzed using Nvivo 14, mobilizing the \"individuals domain\" from the updated Consolidated Framework for Implementation Research.</p><p><strong>Results: </strong>One school had a SFC policy, 6 were in the SFC implementation process, 23 had no SFC policy, and 1 had abandoned it. A majority of deans were unaware that a SFC goes beyond a smoking ban. However, 28 deans held a net-positive perception of SFC, arguing that it is a coherent multi-modal intervention and is effective in reducing smoking. However, SFC were also perceived as stigmatizing smokers and displacing the problem rather than solving it. Perceived barriers to SFC implementation were competing priorities, lack of funding, and opposition from smokers. Perceived facilitators of SFC implementation were access to existing resources, support from medical students, and natural legitimacy of medical schools. Deans felt they had a leadership role to play in initiating, promoting, and enforcing the SFC policy.</p><p><strong>Conclusions: </strong>SFC are poorly developed in medical schools in France, mostly because medical school deans prioritize other issues over smoking prevention and are under-aware of the benefits of SFC policy. However, they hold a net-positive opinion on SFC policy and express a willingness to implement it. We provide a set of practical strategies to help remove the main barriers to SFC implementation.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"316"},"PeriodicalIF":2.7,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143498821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigating facilitators and barriers to the routine provision of HIV PrEP in community pharmacies in London.","authors":"Marsha Alter, Shivali Lakhani, Aos Alaa, Manisha Karki, Eva Riboli-Sasco, Austen El-Osta","doi":"10.1186/s12913-025-12336-1","DOIUrl":"https://doi.org/10.1186/s12913-025-12336-1","url":null,"abstract":"<p><strong>Background: </strong>The United Kingdom's (UK) integration of Pre-exposure Prophylaxis (PrEP) into community pharmacies presents an alternative avenue for supporting Human Immunodeficiency Virus (HIV) prevention. Despite its effectiveness, PrEP's accessibility remains hindered by various barriers within community settings. The aim of this study was to explore the perspectives of pharmacy team members regarding the barriers and facilitators to the routine provision of PrEP in community pharmacies in the UK, as well as any recommendations for mitigating these challenges.</p><p><strong>Methods: </strong>Exploratory mixed-method cross-sectional study utilising an online survey and semi-structured interviews with community pharmacists and non-pharmacist team members across the North Thames area of London, England. A convenience sample of 110 pharmacy team members participated in the study, including both pharmacists and non-pharmacists. Two pharmacy technicians and eight pharmacists took part in semi-structured interviews. Data collection involved a cross-sectional online survey and semi-structured interviews. The survey collected data such as demographic characteristics, knowledge, and attitudes towards PrEP provision, while interviews explored in-depth perceptions, experiences and recommendations.</p><p><strong>Results: </strong>A significant proportion of respondents expressed a lack of confidence and knowledge regarding PrEP, with training identified as a critical need for facilitating PrEP provision. Additionally, the study highlighted the potential of community pharmacies to increase accessibility of PrEP due to their geographical reach and the trust placed in pharmacists.</p><p><strong>Conclusion: </strong>The study demonstrates an interest from community pharmacies in London in providing a commissioned PrEP supply service. However, this would need to be in conjunction with training programmes and public health campaigns to equip community pharmacies for effective PrEP provision. Enhancing pharmacists' competencies and raising public awareness could significantly support the current HIV prevention strategies in the UK.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"312"},"PeriodicalIF":2.7,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143498799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Strategies for improving maternal care for ethnic minority women with obstetric anal sphincter injuries in the UK.","authors":"Olufisayo Olakotan, Vedhapriya Sudhakar, Jennifer Nw Lim, Mina Bhavsar, Farah Siddiqui, Rabina Ayaz, Gillian O'Brady Henry, Thillagavathie Pillay","doi":"10.1186/s12913-025-12441-1","DOIUrl":"https://doi.org/10.1186/s12913-025-12441-1","url":null,"abstract":"<p><strong>Background: </strong>Women from minority ethnic groups in the UK have the highest prevalence of obstetric anal sphincter injuries (OASI), including third- and fourth-degree perineal tears sustained during childbirth. Incorporating the voices of mothers at higher risk of OASI is crucial in developing strategies to improve care and well-being.</p><p><strong>Aim: </strong>To identify strategies perceived as important by women with lived experience of OASI in Leicester, UK, to improve their care and well-being.</p><p><strong>Methodology: </strong>Women at high risk of and with lived experience of OASI in Leicester, UK, were invited, through our local maternity and neonatal voices partnership, to participate in a virtual focus group discussion (FGDs). Two FGDs were conducted to accommodate participants' availability. The first session included seven women, while the second session included three women. All participants were from underrepresented groups with lived experiences of OASI within the past one to ten years. A discussion guide was used to explore participants' perceptions and experiences of OASI care, as well as their views on culturally and linguistically sensitive maternal care strategies. The discussion was recorded and transcribed. The data were analysed using the six-step thematic analysis approach by Braun and Clarke.</p><p><strong>Results: </strong>The participants identified strategies to provide culturally appropriate care for obstetric anal sphincter injuries, including linguistically accessible prenatal resources, comprehensive midwifery training, updated prenatal education, standardized postpartum care, the inclusion of fathers in prenatal education, empathetic care, building trust, and community engagement and education.</p><p><strong>Conclusion: </strong>This study highlights disparities in maternal healthcare outcomes for women from diverse ethnic backgrounds who experience OASI. Addressing these inequalities requires incorporating the voices of those directly affected to inform culturally sensitive policies and practices in maternal care.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"313"},"PeriodicalIF":2.7,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143498820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Barriers to healthcare services utilisation among women in Ghana: evidence from the 2022 Ghana Demographic and Health Survey.","authors":"Florence Gyembuzie Wongnaah, Augustus Osborne, Precious Adade Duodu, Abdul-Aziz Seidu, Bright Opoku Ahinkorah","doi":"10.1186/s12913-025-12226-6","DOIUrl":"https://doi.org/10.1186/s12913-025-12226-6","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Access to healthcare is vital to women's health outcomes, as emphasised in the Sustainable Development Goals. This study aimed to assess the factors associated with barriers to healthcare utilisation among women aged 15-49 years in Ghana.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Data from the 2022 Ghana Demographic and Health Survey was used for the study. The study included 15,014 women. Regional variations in the proportion of respondents with healthcare access were visualised using a spatial map. A multivariable binary logistic regression analysis was conducted. The results were presented as adjusted odds ratios (aORs) with 95% confidence intervals (CIs).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;In Ghana, 53.6% [51.7, 55.5] of women reported barriers to healthcare utilisation. Women aged 25-29 years [aOR = 1.245; 95% CI: 1.01, 1.53] and 45-49 years [aOR = 1.377; 95% CI: 1.04, 1.82] had higher odds of facing barriers in healthcare services utilisation than those aged 15-19 years. The odds for experiencing barriers to healthcare utilisation were higher among women with two [aOR = 1.290; 95% CI: 1.06, 1.56], three [aOR = 1.478; 95% CI: 1.20, 1.82], and four or more children [aOR = 1.306; 95% CI: 1.05, 1.63], women of Ewe [aOR = 1.325; 95% CI: 1.07, 1.63], or Mole Dagbani ethnicity [aOR = 1.512; 95% CI: 1.22, 1.87] compared to those with no children and Akan women respectively. Lower odds were observed among women with higher education [aOR = 0.642; 95% CI: 0.49, 0.84], married [aOR = 0.555; 95% CI: 0.47, 0.66] or cohabiting women [aOR = 0.646; 95% CI: 0.55, 0.76], Muslims [aOR = 0.770; 95% CI: 0.64, 0.92], who watched Television [aOR = 0.776; 95% CI: 0.68, 0.88], and internet users [aOR = 0.765; 95% CI: 0.67, 0.87]. Those in the poorer [aOR = 0.666; 95% CI: 0.54, 0.82], middle [aOR = 0.453; 95% CI: 0.36, 0.58], richer [aOR = 0.368; 95% CI: 0.28, 0.48] and richest [aOR = 0.247; 95% CI: 0.18, 0.34] wealth quintile were less likely to experience barriers to healthcare services utilisation compared to the poorest. Regionally, women in Volta [aOR = 0.478; 95% CI: 0.33, 0.68], Bono [aOR = 0.488; 95% CI: 0.32, 0.76], and Upper East [aOR = 0.382; 95% CI: 0.21, 0.71] regions had lower odds of experiencing barriers to healthcare utilisation than those living in the Western region.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;A higher proportion of women in Ghana experience barriers to healthcare utilisation. Older age, higher parity, higher educational attainment or level, access to media, religion, ethnicity, wealth index, marital status, and geographical region were factors identified to be associated with barriers to healthcare utilisation in Ghana. It is recommended that policymakers prioritise interventions aimed at addressing regional disparities in healthcare infrastructure, improving geographic accessibility to healthcare services, and tackling socioeconomic, cultural, and social determinants of health. Efforts should focus on strengthening com","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"305"},"PeriodicalIF":2.7,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143498609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Educational interventions delivered to prescribing advisers to influence primary care prescribing: a very low-cost pragmatic randomised trial using routine data from OpenPrescribing.net.","authors":"Helen J Curtis, Brian MacKenna, Bhavana Reddy, Alex J Walker, Sebastian Bacon, Rafael Perera, Ben Goldacre","doi":"10.1186/s12913-024-11575-y","DOIUrl":"https://doi.org/10.1186/s12913-024-11575-y","url":null,"abstract":"<p><strong>Background: </strong>NHS England issued commissioning guidance on 18 low-priority treatments which should not be routinely prescribed in primary care. We aimed to monitor the impact of an educational intervention delivered to regional prescribing advisors by senior pharmacists from NHS England on the primary care spend on low-priority items.</p><p><strong>Methods: </strong>An opportunistic randomised, controlled parallel-group trial. Participants (clinical commissioning groups, CCGs) were randomised to intervention or control in a 1:1 ratio. The intervention group were invited to participate. The intervention was a one-off educational session. Our primary outcomes concerned the total prescribing of low-priority items in primary care. Secondary outcomes concerned the prescribing of specific low-priority items. We also measured the impact on information-seeking behaviour.</p><p><strong>Results: </strong>40 CCGs were randomised, 20 allocated to intervention, with 11 receiving the intervention. There was no significant impact on any prescribing outcomes. There was some possible evidence of increased engagement with data, in the form of CCG email alert sign-ups (p = 0.077). No harms were detected.</p><p><strong>Conclusions: </strong>A one-off intervention delivered to CCGs by NHS England did not significantly influence low-priority prescribing. This trial demonstrates how routine interventions planned to improve uptake or adherence to healthcare guidance can be delivered as low-cost randomised trials and how to robustly assess their effectiveness.</p><p><strong>Trial registration: </strong>ISRCTN31218900, October 01 2018.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"308"},"PeriodicalIF":2.7,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143498779","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Uptake, scale up, integration of caccine, immunization, and health supply chain management technologies and innovation into policy: experience from Tanzania.","authors":"Henry A Mollel, Lawrencia D Mushi, Richard V Nkwera","doi":"10.1186/s12913-025-12383-8","DOIUrl":"https://doi.org/10.1186/s12913-025-12383-8","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The uptake, scale-up, and integration of technologies and innovations have been the emphasis of the government of Tanzania for sustained health systems strengthening. This study sought to assess the state and factors for the uptake, scale-up, and integration of Vaccine, Immunization, and Health Supply Chain Management (VIHSCM) technologies and innovations into policy, drawing on experiences from Tanzania.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;An exploratory descriptive cross-sectional design with a mixed approach was conducted to assess associated factors for uptake, scale-up, and integration of VIHSCM technologies and innovative solutions for a wide coverage of the quality of vaccines. The data were collected from purposively and conveniently key informants from national, regional, district, and a health facility. A questionnaire was administered to 37 respondents at the health facility level and in-depth interviews were conducted with 104 key informants across all levels. Two Focus Group Discussions (FDGs) comprising 3 and 8 key informants were in one faith-based organization and a privately owned health facility respectively. An observational checklist and desk review were implemented to collect additional data and validation. As regards data analysis, qualitative data were thematically analyzed and quantitative data were analyzed descriptively using SPSS version 21.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The findings show that a range of innovations and technologies have been implemented for VIHSCM, with a primary focus on management and storage to guarantee consistent availability and caliber of vaccinations. Although the advantages of these technologies in improving availability and coverage are well acknowledged, the state of implementation indicates several challenges. Vaccine Information Management System (VIMS) has been put into practice at the council, regional, and national levels. Nevertheless, their efficacy is hampered by their continued fragmentation and lack of integration. Comparably, just 15 councils report that Tanzania Immunization Registry (TImR) has sufficient capability at the facility level. The potential influence of these technologies on VIHSCM is undermined by their incomplete scale-up and limited usefulness. Furthermore, the Remote Temperature Monitoring (RTM) tool, crucial for maintaining vaccine quality, is only operational up to the council level and suffers from inadequate integration. Consequently, many health facilities still rely on outdated methods like 30-day temperature loggers, which may compromise the integrity of temperature-sensitive vaccines.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The value of technologies and innovations for improving VIHSCM is highly recognized for facilitating high-quality, effective, efficient, and equitable immunization services. However, the adopted technologies and innovations have been beneficial to only a small group of the population and for a short time because","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"306"},"PeriodicalIF":2.7,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143498724","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Workplace bullying among medical laboratory professionals in Ghana: insights from self-reported experiences, challenges to mitigation structures, and coping strategies.","authors":"Evans Duah, Richard Kobina Dadzie Ephraim, Gabriel Pezahso Kotam, Samuel Mawuli Kumordzi, Samuel Amoah, Nii Armah Addy, Solomon Dzidzornu Yao Kwashie, Abu Abudu Rahamani","doi":"10.1186/s12913-025-12458-6","DOIUrl":"https://doi.org/10.1186/s12913-025-12458-6","url":null,"abstract":"<p><strong>Background: </strong>Workplace bullying is a major concern in Ghana's healthcare sector, often arising from power imbalances and an excessive emphasis on achieving results at the cost of employee well-being. While bullying among healthcare professionals like doctors and nurses is well-documented, little is known about its prevalence among medical laboratory professionals, who play a vital role in patient care. We assessed bullying in this group to inform strategies for mitigation.</p><p><strong>Methods: </strong>We conducted a cross-sectional survey involving 378 medical laboratory professionals. The survey included demographic information, workplace characteristics, the Revised Negative Acts Questionnaire (NAQ-R), and questions about bullying perpetrators, mental health breaks, and anti-bullying policies. Data analysis involved descriptive statistics, the Kruskal-Wallis test, and logistic regression. Results were reported as frequencies, percentages, and odds ratios with 95% confidence intervals (CIs), and statistical significance set at p < 0.05.</p><p><strong>Results: </strong>44% of the medical laboratory professionals reported experiencing bullying; 29% faced frequent bullying, while 71% encountered it occasionally. Common issues included ignored opinions, unmanageable workloads, gossip, and exclusion. Non-clinical administrative managers were the most frequent perpetrators. Diploma and bachelor's degree holders had higher odds of being bullied compared to master's degree holders (AOR = 6.13, p = 0.013; AOR = 2.56, p = 0.007). Rural professionals had higher odds than urban counterparts (AOR = 2.23, p = 0.007).</p><p><strong>Conclusion: </strong>The high prevalence of workplace bullying among medical laboratory professionals highlights the need for effective policies to enhance workplace conditions and patient care.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"310"},"PeriodicalIF":2.7,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143498726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spatial-temporal analysis of patient complaints in Shanghai from 2015 to 2022.","authors":"Gan Wang, Chaowei Wu, Ye Yao, Tiantian Zhang","doi":"10.1186/s12913-025-12350-3","DOIUrl":"https://doi.org/10.1186/s12913-025-12350-3","url":null,"abstract":"<p><strong>Objective: </strong>Patient complaints are crucial for improving the service quality of hospitals and healthcare professionals as well as enhancing patient satisfaction. The 12320 and 12345 hotlines in Shanghai are key platforms for receiving public health complaints. Understanding the temporal and spatial changes in the growth rate of patient complaints in Shanghai is essential for resource allocation and service quality improvement.</p><p><strong>Methods: </strong>This retrospective study investigated the spatial distribution characteristics of the growth rate of patient complaints in Shanghai's sub-districts from 2015 to 2022, involving a total of 326,147 patient complaint cases. We used ArcGIS 10.2 to analyze the annual trends in complaint volume, perform spatial autocorrelation analysis, hot-spot analysis (Getis-Ord Gi*), and content analysis based on the Healthcare Complaint Analysis Tool (HCTA).</p><p><strong>Results: </strong>The volume of patient complaints showed a continuous upward trend from 2015 to 2022. The Moran's Index for the two periods of 2015-2019 and 2015-2022 was 0.020 (P = 0.036) and 0.045 (P = 0.001), respectively. Patient complaints exhibited strong spatial clustering effects in certain street areas, particularly in the western suburbs, where the growth rate of complaints was more severe than in central urban areas. The top three types of complaints in focus areas in 2022 were environment, safety, and institutional processes, accounting for 45.93%, 13.73%, and 18.24%, respectively. Hotspot areas were concentrated in the western and southwestern parts of Shanghai, with the main complaint stages occurring during admission, examination and diagnosis, and surgery and procedures.</p><p><strong>Conclusion: </strong>This study explored the methodological approach to studying the temporal and spatial distribution of patient complaints. Shanghai should focus on healthcare complaints from the western and southwestern suburbs. Future resource allocation and service quality improvement should target these high-complaint regions and frequently complained issues to enhance patient satisfaction and overall healthcare quality.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"311"},"PeriodicalIF":2.7,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143498819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Facility readiness and experience of women and health care providers in receiving and delivering obstetric care in comprehensive health posts in Ethiopia: a mixed method study.","authors":"Temesgen Ayehu, Gizachew Tadele Tiruneh, Chala Tesfaye, Mebrie Belete, Nebreed Fesseha, Agumasie Semahegn, Hillina Tadesse, Alemnesh Hailemariam Mirkuzie, Yeshiwork Aklilu, Mintiwab Zenebe, Miftah Yasin, Abdela Mohammed, Abdulbasit Hamza, Omar Mohammed, Wendemagegne Embiale, Mesele Damte Argaw, Dessalew Emaway","doi":"10.1186/s12913-025-12453-x","DOIUrl":"10.1186/s12913-025-12453-x","url":null,"abstract":"<p><strong>Background: </strong>Maternal mortality remains a critical public health issue in Ethiopia, with only half of births occurring in health facilities. To address this, the Health Extension Program (HEP) introduced comprehensive health posts (CHPs) to improve maternal and newborn health services in underserved areas. The CHPs are expected to provide essential health services to communities who live in villages that have limited access to a health center or Primary Hospital (more than one-hour walking distance). This study assessed the readiness of CHPs to deliver obstetric care and explored the experiences of women and healthcare providers.</p><p><strong>Methods: </strong>A mixed-methods approach was used, combining quantitative assessments of eight CHPs using World Health Organization (WHO) service readiness tools and qualitative interviews with 22 postpartum women and 16 healthcare providers in agrarian and pastoral settings. Readiness indicators included staffing, availability of essential equipment, and service provision, while qualitative data focused on care experiences, respect, and interactions with providers.</p><p><strong>Results: </strong>The CHPs had a mean readiness score of 50% for childbirth services, with agrarian settings scoring higher than pastoral ones. Staffing density averaged 4.3 health professionals per 5,000 population. While 63% of CHPs had access to water and electricity, power outages and water shortages significantly impacted service delivery. Women reported positive experiences, highlighting compassionate care and improved access due to proximity to CHPs. However, they noted infrastructure gaps, limited supplies, and training deficiencies. Healthcare providers identified frequent stockouts, staffing shortages and inadequate capacity-building opportunities as key challenges.</p><p><strong>Conclusions: </strong>Enhancing CHPs' operational capacity is essential to improving maternal health outcomes in rural Ethiopia. Investments in infrastructure, training, and consistent supply chains are critical to address existing gaps and ensure sustainable progress in maternal and newborn care.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"25 1","pages":"303"},"PeriodicalIF":2.7,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143490630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}